Passing Step 1 of the United States Medical Licensing Examination (USMLE) on your first attempt is a vital step on the road to residency, but it’s hardly easy.
Jason Ryan, MD, MPH, is the founder of Boards & Beyond, an online medical education platform that offers USMLE test-prep resources. Success on the exam, he said, is tied to approaching your studying with the right strategy, and Dr. Ryan offered these essential medical student test-prep tips.
Start studying early
The foundation for Step 1 success is laid during the opening months of medical school. Medical students build on that foundation until they take the exam.
“You want to set yourself up so when you reach your dedicated study period, you have a strong foundation and you can mostly focus on practice questions for that entire dedicated,” Dr. Ryan said. That means, you know, during your first year, building your foundation and then in your second year continuing to build it.”
Students in the U.S. and around the globe use Boards & Beyond subscriptions to supplement their classes and prepare for board exams, core clerkships and successful careers. An offer available to new AMA members includes a free three-month subscription to one of three Boards & Beyond series.
Practice questions make perfect
Medical students who struggle to pass the exam often fail to do enough practice questions in the final stretch leading up to their Step 1 exam day.
“Practice questions are like free-throw reps in basketball,” Dr. Ryan said. “You just take them, keep taking them, keep seeing things and getting comfortable.
“You want to see practice questions and say: OK, I understand the words that they’re using. I understand what they’re going for here, but let me see if I can get exactly the point this question is after.”
Know your test-taking ability
Your performance on preclerkship exams acts as a barometer for your overall skill in taking standardized tests. The USMLE Step 1, like most standardized exams, favors good test-takers.
“If tests are hard for you, like your MCATs or preclinical tests, then that's just a sign that you need to put in extra time to get ready for Step 1,” Dr. Ryan said, referring to the Medical College Admissions Test.
Transition to active studying
Passive study methods are key in building a foundation, but they have less value as time goes on.
“By watching Boards & Beyond videos or going to your medical school classes or reading textbooks, you can gain a basic understanding of lots of things about medicine,” Dr. Ryan said. “When you’re close to an exam, that's when you want to do less of that passive learning and you really just want those reps of questions.”
Dr. Ryan said that once medical students reach crunch time—typically considered the dedicated study window, which takes place four to eight weeks prior to an exam date—they should be doing between 40–100 practice questions a day.
Let your QBank guide content focus
Use your performance on practice questions, often those in a question bank, to guide your Step 1 content review. While it’s important to review both one’s correct and incorrect answers, if a medical student is consistently missing questions in one content area, they may need to revisit foundational resources to address gaps.
“When you get questions wrong, you have to spend a little time figuring out: Why did I get it wrong?” Dr. Ryan said. “Was I just fooled by wording, or is this really a topic that I’m really lost on?”
Know where you stand on Step 1
Your USMLE score doesn’t have to come as a surprise. Dr. Ryan said medical students should use practice exams from the National Board of Medical Examiners as one key resource to gauge readiness. To feel good about your prospects, a score around 70% is generally where you want to be.
If a student is consistently scoring in the 50s or low 60s, Dr. Ryan said it may be worth delaying the exam.
“A failure on Step 1 is an enormous change to your prospects out of medical school for residency,” he said.
Prioritize well-being
Maintaining your well-being as a medical student is a key aspect of preparation.
“When I was studying for Step 1, it was the first time in my life I felt like I had to go to the gym,” Dr. Ryan said. “If I missed, I was going to feel terrible, and I couldn't wait to get there.
“If you're not sleeping enough and you're eating all junk food and you're not getting any exercise, it's going to be much harder on your body.”
The AMA offers essential tools and resources to support medical students in their preparation for the USMLE series of exams. To help you with your studies, AMA members receive a discount on test-prep materials for the USMLE and the Comprehensive Osteopathic Medical Licensing Exams (COMLEX-USA).
