USMLE Top Tips Practice Questions

USMLE Step 1 Practice Questions: Top Tips

Doing USMLE 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. Questions are a fantastic learning resource (especially for certain types of learners), but their efficacy is diminished when students view them solely as a self-testing tool. Rather, you should initially use questions as a study resource to learn concepts. Once you have a handle on the material, you are ready to move on to using question banks as a self-testing tool.

Types of Multiple Choice Errors

Problem TypeSource of Errors
Format problemsParticular question subtypes
Anxiety problemsQuestions containing numbers, or done early in the review session
Fatigue problemsQuestions done late in the review session
Reading errorsMore common in long questions
Directionality errorsQuestions that ask for prediction of consequences
Group delineation errorsQuestions that present material in a unique context

When you do your practice questions, you can start in an untimed review mode. As you progress in your studies, however, you should increasingly answer blocks of questions under a time limit similar to the actual exam (roughly 90 seconds per question). This way you will get used to the time constraint. It is one of the unchangeable realities of the USMLE.

Common USMLE Step 1 Practice Question Mistakes

When doing practice questions, avoid these 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 1 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. Keeping track of concepts you got wrong in a dedicated notebook or spreadsheet is a good way to outline your weaknesses. Plus, it allows you to easily go back and review these concepts and ensure you have closed these knowledge gaps during your preparation time.
  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. Be sure to use an online question bank as a learning resource. These study tools are updated on a regular basis and are very testlike.
  4. Do not do questions individually. Do them in clusters under time pressure, with 5 to 10 as a minimum. This will get you used to moving from question to question. Do not look up 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.
  6. Consider doing self-assessment exams to test your progress throughout your preparation. Good resources to use for this purpose are Kaplan’s subject assessment exams and simulated exams, as well as the self-assessment exams offered by NBME.

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.

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