Step 1 UWorld Strategies
Written by Grace Gilbert, MD
You know UWorld is important and that there are lots of questions…but where do you start, and how to you use it efficiently is what this blog post will discuss.
Starting in mid-January 2022, USMLE Step 1 and COMLEX Level 1 are pass/fail. It is important to understand that Step 2 builds a lot on Step 1. It’s worth doing a traditional dedicated period and acting like your score matters so you learn the material.
Content and Questions
UWorld is an incredible tool for preparation. It’s also likely the hardest, most demoralizing thing you can do to prepare for the exam.
Group 1: You already have a decent knowledge of the content, which means you should be using the 70:30 rule. 70% of your day should be doing or reviewing questions. Try to make it so 30% of your day is content review. So in a 12 hour study day, a little over 8 hours will be spent on questions.
Group 2: You are struggling to pass the NBME practice exams, so focusing on building your knowledge base is key. Flip the 70:30 rule. Use 70% of your day to improve your content knowledge. Focus heavily on Pathoma and FirstAid. Once you’re ready, jump to group 1 to spend more time on questions.
Daily Schedule
Group 1: Try to do at least two blocks of 40 questions. I would recommend a maximum of three blocks a day if you plan to review all the information that day. The blocks will take about three hours each to answers the questions and review the material. You can choose to do these questions in various formats: timed, tutored mode, random questions, or a specific topic. To get practice, I would advise doing some blocks in timed and random mode to practice for test day.
Group 2: Try to complete 40 questions a day based on the content you are reviewing that day.
Reviewing Questions
Avoid moving forward to the next set of questions until you finish reviewing the block of questions. Many times, students have many unreviewed question blocks. If you are not learning from your questions, they are a waste of time. UWorld is not an assessment, it’s a study tool. I don’t care if you get 30% right or 90% right, if you don’t learn about the things you got wrong, it’s a waste of your time.
So how is that done? I made a flow chart to explain what to do.
For any question you get wrong or guess, you should read the explanation. At the beginning of your dedicated study period, it will take longer to review each question. If you guess on an answer, you can mark the question, and then complete those “marked” questions again later if you have time in your study period. If you get a question incorrect, you can write it down in a document, or in an Anki or Quizlet set.
When reviewing questions, it is also important to identify why you got the question wrong. Was it a knowledge deficit where you truly didn’t know the answer? Or was it a test-taking error where you misread the question? Tally the answers to those two questions up at the end of each block to see if you should be spending more time on content.
When taking notes, avoid simply writing lists of facts. For instance, I could write, “Niemann-Pick has hepatosplenomegaly”, which is technically the fact I got wrong. Or, I could write, “How do you tell the difference between Tay-Sachs and Niemann-Pick’s disease?” which is the issue I was having. For me I strongly suggest using filter decks, I have a video on how and why to use filter decks here.
After reviewing what you got wrong, do a quick read-through of the First Aid section to review more information about that whole disease. It’s also important to glance at similar diseases in that section as well.
For most questions, this is where you stop, but if you know a specific topic is a weakness or a high yield topic, you should go learn more about it via other resources like Sketchy Medical or Boards and Beyond.
It is important to remember that to be a doctor you need to learn these diseases and to pass USMLE Step 1, you need to learn how to answer the questions.
Good luck and be nice to yourself through this stressful journal!
Grace
