Highly Effective Study Methods for the USMLE Step 1

In order to be prepared for the USMLE Step 1, you must have a good grasp on many topics and concentrations. The best way to cover all of the information is to use highly effective study methods.

Each person has his or her own preferred way of studying. You will have to decide what will work the best for you. High-yield study methods all have one feature in common: The more active you are with the material, the more content you will ultimately retain. Remember, your goal in studying is not just to put in the most time, but to be efficient. Many of the best students make use of the following techniques:

  • Ask Yourself Questions

    One of the best study techniques is to pose questions to yourself as you review material. Perhaps you’ll want to jot them down on index cards to share with others and to practice later. By asking yourself questions, you are framing the material, challenging yourself to focus on key areas, and preparing for questions you may well see on the examination. Your goal is not to learn knowledge for general use, but to be able to answer multiple-choice exam questions.

    This strategy will move you from thinking like a student answering questions to thinking like a faculty member who is writing questions. By this process, you “get into” the head of the question writers and begin to understand what makes a good question and the basic science issues likely to be at the core of presented questions.

  • Use Graphs and Charts

    Many common graphs and charts appear repeatedly on the exam. Practice reading graphs, charts, and tables. Try abstracting the salient facts quickly from a graph or chart. This may be expedited by using a plain sheet of paper to cover unneeded information and to focus your attention on selected information.

    Drawing the graph yourself seems to help you remember it more than just looking at it multiple times. Drawing a graph from memory will give you the confidence that you’ve truly mastered the material. The more active you are with the material, the more likely you are to both remember it and understand important nuances.

    You’ll see lots of tables, graphs, and charts on the exam, so practice using these tools.

  • Paraphrase

    Practice paraphrasing material to highlight important information. Paraphrasing means processing the material you have read; telling yourself what is important and unimportant as you read through it, and summarizing the key content in your own words.

    Pretend that you are the teacher who is in charge of presenting the content. What would you choose to emphasize? What would you leave out if you were short on time? How would you explain the concept to someone new to the field? Remember, if you can say it in your own words, then you really know it.

    The art of paraphrasing will allow you to answer questions with extensive information in the stem, such as case histories, much more efficiently. Many students say the most difficult part of the USMLE is getting through the large volume of reading required for each question. When you are paraphrasing, you do not treat every piece of information with the same emphasis, but decide what is important and what is not. Developing this skill will also be helpful as you progress through your medical career.

  • Summary Notes

    Creating summary notes is a great study technique and will reinforce your paraphrasing skills. Summary notes are your personal representation of key points in the material written in a way that makes sense to you. Summary notes should run parallel to your primary study material and should serve to annotate, illustrate, and amplify the key points of that material. The physical action of simply writing the notes tends to reinforce learning and aid long-term retention. Once completed, summary notes provide a ready guide for those times when you review the material.

  • Study Groups

    Study with friends or colleagues in groups of four or five. The best groups comprise people with a range of expertise. Try to form a group where each person’s weakness is complemented by someone else’s strengths.

    The goal of these study groups is not to show your colleagues how much you know. Rather, it’s to find the holes in your knowledge while you still have time to correct those gaps. Don’t be afraid to tackle the tough topics. With the aid of your study group, things will make sense much sooner than they will on your own. Challenge each other. Pose hypothetical situations and seek agreement as to the best answers.

  • Plan Your Study Time

    For most efficient studying, avoid cramming and plan to re-review key material on a regular basis. Repeated exposure to material over time leads to more thorough retention than one massive concentrated exposure.

    In your final reviews, remember that active learning is best. This means avoiding simply reading the same page of notes over and over. Instead, use key words as mental triggers and tell yourself as much as you can about the topic you are studying. For example, don’t simply re-read the Krebs cycle. Rather, tell yourself about it as if you were explaining it to someone else, and then check your explanation against your notes.

    Re-review is also the time to begin to make links among different sections of your material. What does your understanding of the physiology of the cardiovascular system tell you about common pathology or pharmacologic intervention? The threads of common diseases weave through each of the basic science subjects; tie them together and provide a framework that aids in retention.

  • Practice with Testlike Practice Questions

    Doing practice questions is essential in your preparation for taking a multiple-choice exam. Your goal here is to test yourself and also to learn good question-answering habits. As you do questions, examine whether you got them right, but more importantly, look at why you got the question right or wrong. Did you not know the content? Then that’s your cue that more study is needed. Did you misread the question? Then evaluate how you misread it and learn how the question writer wants you to read it.

Sources of Multiple-Choice Errors

Format problemsParticular questions about subtype
Anxiety problemsQuestions containing numbers, or done early in the review sessions
Fatigue problemsQuestions done late in review session
Reading errorsMore common in long questions
Directionality errorsQuestions that ask prediction of consequences
Group delineation errorsQuestions that present material in a unique context

When you do your practice questions, do them under a time limit similar to the actual exam. In general, your rule should be one minute per question. This is roughly the amount of time (82 seconds) you will have during the real exam. Get used to the time constraint. It is one of the unchangeable realities of the USMLE.

Common Mistakes

1. Do not do questions without preparatory studying. Review material first until you feel you know it, and then use questions to test yourself. If you study by doing questions before you are ready, you will erode your self-confidence and fail to develop key linkages within the material.

2. Do not get into the habit of lingering over a question. You do not have this luxury on the real exam. Remember that you have just over one minute per question. You should spend about 75 percent of that time reading and analyzing the question stem, and the other 25 percent selecting an answer. Be honest when you do not know an answer; move on, and look it up when you are finished.

3. So-called “retired questions” and many published questions in review books are not representative of questions featured on the current USMLE Step 1. They are a reasonable way to review content, but often do not reflect the length or form of the questions on the current exam.

4. Do not do questions individually. Do them in clusters under time pressure, with five to ten as a minimum. This will get you used to moving from question to question. Do not lookup answers after each question. Instead, check yourself after you have done the full set of questions.

5. When you start working on questions, do not panic if you do not get the correct answers. Learn from your mistakes. Questions are a part of the study process; they help you see what else you need to learn. You will get better at questions as your studying continues.

Try This Question-Mastering Exercise

Cover up the options to the question and read the question stem. Pause at each period and paraphrase what you have read. When you finish reading the question, cover the question and reveal the options. Select from the options without looking back at the question stem. With practice, you will get faster, and this strategy will become a habit. This strategy forces you to get the information out of the question as you read it and does not allow you to waste time by going back and rereading. Remember, you only have time to read each question once. Learn to make your reading time as efficient as possible.