It’s Exam Season! Things To Do Before Your USMLE Test

The USMLE exams are an important part of your journey to become a medical doctor. Whether it’s USMLE Step 1, USMLE Step 2, or USMLE Step 3, you are likely feeling a bit nervous – and that’s normal. However, we want you to get past those feelings to actively plan and prepare to ace the test! Now let’s consider some of the things you can do before your USMLE test to ensure your best performance.

How to Pass the USMLE Test

Before we get into the exam prep tips, let’s quickly consider what you need to know about how to pass the USMLE test:

USMLE Step 1

The USMLE tests are structured differently and they have different passing scores. In the case of USMLE Step 1, there are 280 multiple-choice questions arranged into seven 60-minute blocks of 40 questions each. Although you’ll get breaks, prepare yourself for a full day of testing! USMLE Step 1 tests your knowledge and application of core medical principles and mechanisms in diagnoses and treatment of diseases, as well as modes of therapy.

The passing score for USMLE Step 1 is 194. But, you need to aim for a higher score, as your performance in this exam is very important for your choice of residency internship. We recommend aiming for a score of 240 or better. Yes, it’s high, but you want to get into the best residency program. So maximize that score!

USMLE Step 2

Your USMLE Step 2 exam consists of Step 2 CS and Step 2 CK. The USMLE Step 2 CS is a one-day, 8-hour clinical skills exam. You’ll investigate the complaints of a series of standardized patients (actors) and make appropriate recommendations. There will be 12 patient encounters and 15 minutes for you to assess each one. The good news? USMLE Step 2 CS is a pass/fail test.

USMLE Step 2 CK tests your application of medical knowledge and skills, as well as your understanding of clinical science. It assesses how well you can provide patient care under supervision and emphasizes health promotion and disease prevention. The USMLE Step 2 CK test consists of eight 60-minute blocks of 40 questions each (but the total number of multiple-choice questions will not exceed 318). USMLE Step 2 CK is more clinically-focused, and you need to have a firm grasp of  the principles in medicine, surgery, pediatrics, obstetrics and gynecology, and psychiatry, as well as patient safety, legal/ethical issues, and professionalism.

A passing score for USMLE Step 2 CK is 209 and above. But, we don’t want you to aim for a mere pass. A score of 250 and above puts you in a competitive position – especially if you’re going to specialize in surgery. Let’s aim for the stars with each of these tests!

USMLE Step 3

USMLE Step 3 is the final milestone on your journey to medical practice without supervision. So if you’re at Step 3, take a moment to celebrate your achievements thus far; you’ve come a long way!

You will likely take this USMLE test during your residency program. You will have many demands on your time as you juggle residency requirements, USMLE Step 3 test prep, and your obligations. But, persevere! You’re near the end and you can’t give up now!

USMLE Step 3 is a two-day exam. The first day consists of six 60-minute blocks of 38-39 multiple choice questions (a total of 232 questions). These questions focus on the foundational sciences, biostatistics, interpretation of medical literature, patient safety, communication and interpersonal skills, and medical ethics.

Day 2 of USMLE Step 3 consists of six 45-minute blocks of 30 multiple choice questions each (180 questions in total). The emphasis will be on Advanced Clinical Medicine (ACM), patient diagnosis, and disease management. You’ll also have 13 computer-based case simulations (CCS) that you’ll need to complete in 10-20 minutes each. They will test your skills in patient diagnosis and disease management. So make sure that you’re solid in your knowledge of patient history, physical examination, and use of diagnostic studies.

The passing score for USMLE Step 3 is 198. But, you already know: don’t aim for a mere pass. Aim for an excellent score to close out the USMLE exams in a spectacular way!

Quick Tips for USMLE Test Preparation

Now that you’re clear on what each USMLE test entails, let’s consider some useful tips that will help you to prepare and also perform at your best on your USMLE test day:

Get a Study Plan

You need to have a study plan for your USMLE test.

If you fail to plan, then you plan to fail. And we don’t want you to fail; we want you to excel. The first step is to get a schedule in place. No, you won’t study when you have time – we know what happens when you leave studying for your “free” time: it never happens!

We recommend that you create a study plan that specifies how much time you will spend reviewing your course materials and taking practice tests. Medlearnity can help you optimize your study plan for the best results by offering expert tutoring that’s aligned with the USMLE test.

Be sure to schedule break times, as well as time to socialize with your family and friends. Having regular breaks will help you to be more refreshed and far more productive in your study sessions.

Use Study Groups Wisely

Yes, you can join a study group to have a sense of community as you prepare for your USMLE test. But, beware! Your study group should cover all the material and not get bogged down in a set of topics that some persons may not understand. You want to have a group of persons with complementary strengths so that you can equally benefit from the group.

However, even if you are a part of a study group, you still need your solo study sessions. Set aside time to identify your strengths and weaknesses, and implement strategies to get better in understanding and applying the content.

Practice Makes Perfect: Utilize Question Banks

Each USMLE test is a marathon of sorts – you have a ton of questions to complete in a set time frame. So a key part of your preparation needs to include practice questions. We recommend that you complete as many questions as you can from the UWorld question bank for your test. If you exhaust that resource, then move on to the AMBOSS question bank. Just keep practicing as much as you can!

However, here’s a cautionary note: When you are completing these practice questions, make sure that you can justify your answers every time. You need to be clear on why each answer is correct, and also why the other options are incorrect. Go over your missed questions in detail to ensure that you understand where you made the error in your reasoning and answer choice.

Make sure that you are also timing yourself as you take these practice questions. The USMLE test will be timed, so you need to get in the habit of completing the questions following the same time blocks that you will encounter in the actual exam. That way, your USMLE test day will almost feel like another day in your study session!

Take NBME Self-Assessments

You want your study sessions to be effective, so that means that you need to objectively chart your progress. We recommend that you take an NBME self-assessment at the beginning of your study period. Yes, the score will likely not be great, but that’s OK. You simply need to have a baseline score, an initial assessment of where you’re starting from.

As you progress through your study sessions, continue to take these NBME practice exams. Your scores will help you to identify your weak areas so that you can address them before your USMLE test date rolls around. Plus, you’ll get extra motivation to study when you can see your progress from one self-assessment score to the next. Make sure that you’re celebrating your small wins as you continue to prepare for your USMLE test.

Sleep! Seriously – You Need to Sleep

We know that you’re studying a lot and you feel as though sleep is the last thing that you need. But, make sure that you’re getting adequate sleep each night – it helps your brain function better and that makes for a better score on your USMLE test.

Try sitting in a comfortable position in a dimly-lit room. You can rest your eyes, or you can try reading a book (don’t get on any screens though to avoid excessive stimulation). When you feel yourself drifting off to sleep, don’t fight it.

You also want to get in the habit of sleeping at night. Why? Well, these USMLE exams tend to begin in the morning. So when you are well-rested, then you will experience more productive mornings as you study, and on the day of your USMLE test.

Simulate Your USMLE Test

You have studied and practiced as much as you can. Now, you also need to create the exam conditions at home and complete your USMLE test – before the actual exam. Complete two or more full-length USMLE tests, and be sure to incorporate all the breaks and snacks as well. You want to ensure that you are completely at home in the exam room for your actual test day so that you can focus on doing your best on the exam.

Plan for Your Test Day

Plan for your USMLE test day.

You will likely need to travel to your test site. Make sure that you map out your travel route and time to avoid any problems with traffic and late arrival. Figure out all the parking details ahead of time as well. You can take a practice drive and park at the test center a few days before your USMLE test date. If possible, tour the test center and figure out where the restrooms and other facilities are located. You don’t want to waste valuable minutes on your test day.

Just before your test day, you will feel some anxiety – that’s normal. On the day before your USMLE test, you can stop studying from in the afternoon. Simply relax and get yourself mentally ready for the next day.

If you’re a breakfast person, make sure that you have a healthy breakfast – it’s gonna be a long day! You also need to plan what snacks and lunch to take along with you on the day. Opt for easy, high-energy, and nutritious foods like granola bars and wraps. If you’re a coffee person, have your supply on hand. Do whatever you need to do to be in the best physical, mental, and emotional state to ace your USMLE test!

Manage Your Breaks on Test Day

The adrenaline rush may tempt you to keep working at each block of questions without stopping. But, even then, breaks are useful. If you feel like taking a 30-second break while doing a block of questions, pause the test and take a quick breather. Calm yourself by taking deep breaths and counting backward from ten. Then, get back to the test.

Each USMLE test gives you a set number of minutes for your breaks and lunch. It’s up to you how to use them. However, as a guide (and using USMLE Step 1 as an example) you can do the following:

  • Complete Blocks 1 and 2.
  • Take a 5-minute break.
  • Complete Blocks 3 and 4.
  • Take about 25 minutes for lunch. You can listen to some music and relax as you eat.
  • Complete Blocks 5 and 6.
  • Take another 5-minute break.
  • Complete Block 7.
  • Enjoy the remaining break time! You deserve it!

Don’t Let the Unexpected Upset You

You have prepared as much as you could: but, sometimes life happens. You could forget an item at home, or you may be placed next to a fidgety (or sick) tester. Relax. It’s OK.  You may not have the perfect conditions for your test day, but that’s fine. The main thing is to roll with the punches and not be fazed by anything. Focus on what you can to do: Complete your USMLE test to the best of your ability. Focus. Get it done. Be awesome in the face of it all!

Need Help with Your USMLE Test Course Materials?

Remember, proper preparation prevents poor performance. So make sure that you do all that you can to get the best score on your USMLE test. If you are struggling with your study plan, or certain topics pose a challenge for you, then get the help you need. Medlearnity has a team of highly-qualified practicing physicians who aced their USMLE exams and are now available to help you excel. So whether you are about to complete USMLE Step 1, USMLE Step 2, or USMLE Step 3, let us help you prepare and get your best score. We invite you to sign up for your free 1-hour training session today and see the difference that our elite tutoring makes!

About the author 

Akshay Goel MD

Dr. Goel is a body-trained radiologist and an expert in medical education and imaging informatics. He completed his Radiology Residency at Columbia University Medical Center and his fellowship at Weill Cornell Medicine. Dr. Goel has guided several students and doctors into successful careers over the past decade. He continues to help Medlearnity tutors optimize their educational methodology to drive the highest tutoring and admissions impact possible.

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