Dedicated study time—the window, typically at the end of second year, in which medical students prepare for Step 1 of the United States Medical Licensing Examination (USMLE)—is expected to be stressful. What do you do when, because of a historic pandemic, the window has no finite closing date? You try not to panic.
“My original scheduled test date was going to be May 8,” said Natasha McGlaun, a second-year medical student at the University of Nevada, Reno School of Medicine. “Then it got pushed back to May 15. Then May 20. Now I’m scheduled for some time in the second week of June. They haven’t confirmed my date yet.”
Spring is a key time for USMLE Step 1 test-taking, but with test centers closed through at least May 31, many medical students are left in limbo, awaiting a key milestone.
“It’s been hard trying to be in a mind-set of you still need to be studying and focused, but you also need to use your resources wisely and try to relax,” said McGlaun, an AMA member.
Learn more about the four key questions medical students and residents have about COVID-19 and USMLE testing.
New problem: Too much study time?
McGlaun’s original study plan was to spend eight hours a day on her Step 1 prep. Most of that time would be focused on question banks, with video materials as a supplement. As the time period in which she has had to prepare for the exam has nearly doubled, she has adjusted.
Her original plan called for her to do 80 questions a day. At that pace, she would have run out of test-prep questions. Now she is doing 40. There are also concerns about studying too much.
“It is possible to overstudy,” said Christopher Cimino, MD, chief medical officer at Kaplan Medical. “You get fatigued. There’s a certain speed to how fast you can bring new knowledge in. And there’s a certain speed of decay of the knowledge you’re not using.”
The AMA selected Kaplan Medical as a preferred provider to support you in reaching your goal of passing the USMLE or COMLEX-USA. AMA members can save 30 percent on access to additional study resources, such as Kaplan’s Qbank and High Yield courses.
“If you knew when you were going to take the test,” Dr. Cimino said, “you’d slow down your study plan to reach its peak closer to when you were going to take the test. The problem is most students still don’t know that.”
Dr. Cimino suggested changing study habits to conserve materials and help in the retention of new information. “One approach most people don’t think of is writing potential test questions,” he said. “You can get together with your friends virtually and share questions that you come up with and see if you can come up with variations of these questions. It’s another way to get question practice.”
Uncertainty for test-takers
With exams being postponed, issues of timing and capacity are likely to arise. McGlaun has worked with her medical school advisers to try to secure the earliest possible test date. That is likely a prudent move for any medical student waiting to take the exam.
Beyond that, considering statewide stay-at-home orders, it is unclear whether all test centers will be open on the same date or the openings will be staggered.
“Finding safe solutions to accommodate examinees’ testing needs has been our main focus and highest priority over the past few months,” said a statement issued by the National Board of Medical Examiners (NBME), one of two organizations that oversees the exams. “Due to increasing uncertainty around having wider availability of in-person testing at Prometric test centers, the USMLE program has identified several alternate test delivery methods for Step 1, Step 2 CK, and Step 3 and has begun aggressively pursuing them.”
Those options could include remote test-taking, which has been done with NBME Subject Matter Exams.
As students await word on when and in which format the exams will exist, Dr. Cimino urged them to stay focused on their mission of making a career in medicine.
While medical students may feel helpless during the uncertainty around medical schooling and USMLE testing during the pandemic, “lots of people feel that helplessness because of how their lives have been turned upside down by COVID-19,” he said. “But we need doctors. We need doctors to graduate, to enter the system. We have doctors who are retiring, at the other end of their career, and there need to be doctors who pick up that work. That is going to remain true. As long as there is a delay, there will be large pressure to find a way to shorten that delay. It’s in society’s best interest that students make progress.”
School administrators are aware that external limitations on exams impact students’ progression toward graduation and transition to residency. Many schools are re-evaluating their historical timing of the Step exams in order to keep students moving forward. The Coalition for Physician Accountability, of which the AMA is a part, has launched workgroups to consider downstream implications of educational disruptions related to COVID-19. One of those groups will address how the residency selection process for the class of 2021 needs to adapt, recognizing challenges students face in compiling typical elements, including clinical experiences and Step exam scores.
The AMA has curated a selection of resources to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events.
