by / Monday, 05 September 2011 / Published in USMLE Advice

This is a dreaded reality for all too many smart, intelligent, hard-working medical students… The first thing you need to realize if this unfortunate outcome occurs is that the Step 1 USMLE exam is by no means a gauge as to the quality of your character nor the potential you will have as a future physician.

We work so hard for that one day where we get to sit in front of a computer screen for 8hrs and pull our hair out in frustration, so if you get the results back and they say ‘fail’, then it is almost like a traumatic experience, one that deserves to be mourned as a terrible loss – because to med students that’s exactly how it feels.

So the first thing you need to do if this is you is accept the fact and allow yourself time to heal.  As times passes you will regain your energy and realize that this is nothing more than another obstacle in the seemingly endless stream of obstacles getting in your way… Once you’ve started to feel better, it is time to take a step back and re-evaluate your errors the first time around.

STEP 1Write down the exact strategy you used that was unsuccessful for you – it is important that you are detailed and honest.  If you think you put in 8hr per day but spent half of the time surfing Facebook then you have to be honest with yourself.  If you think you got through UWorld two times, but you failed to attack the qbank the right way for your learning patterns, then you need to ask yourself whether you really learned everything you could from the qbank.

STEP 2 –  Once you’ve written down your study strategy, ask yourself what was useful and what wasn’t – I see way too many med students walking around with the First Aid, the Secrets books, Robbins pathology, one of the many physiology books, etc, etc… but you have to be honest with yourself and determine what you really used and whether that was right for your learning.

STEP 3 – You’ve figured out what you did, you figured out what was useless, now ask yourself what was helpful – once you figure out what was actually helpful you need to add it to your new study regimen.

STEP 4 – Don’t use a ‘review’ book as a way to learn things you don’t yet know in-depth – this is one of the most common reasons why students fail the exam… They take the advice of students who already understand medicine on so many levels that they see First Aid as a tool for reminding them of what is high-yield, but the difference is those students can look at a high-yield nugget and derive boatloads of information from them.  If you cannot look at the simple Parkinson’s disease image in First Aid and from there derive 10 minutes worth of talking points, then you aren’t going to pass using the First Aid as your source of preparation.  KEY:  First Aid is useful when you know the in-depth information about the high-yield stuff, knowing the surface of the high-yield information is a recipe for disaster.

STEP 5 – Do only 1 question bank, but do it the right way – this means focusing on using the questions as a tool for learning instead of focusing too much on the percentages you get correct.  You should be doing questions in blocks of 40-50 at a time, then going back after the block is done to figure out why you were right or wrong.  If you take your time and actually learn from the question bank, it won’t matter what percentages you get because you will actually be learning instead of just pumping yourself up with falsely elevated scores.

STEP 6 – Put together a study schedule to fit your goals, fit your time-frame, and focus on your weaknesses – this is self-explanatory, once you’ve dissected all the reasons why you may have failed, you need to learn how to study effectively in order to meet your goals and improve on your weaknesses.

STEP 7 – Don’t be afraid to seek or ask for help – there are people out there who dedicate a good chunk of their time to teaching students, don’t be afraid to ask them for help.

STEP 8 – Work your butt off – this is the hardest test in the world, it is designed to make you fail, so you should be prepared to work insanely hard in passing it.  Remember, Rome wasn’t built in a day, so you shouldn’t expect to go from failing to scoring a 250 overnight, but if you make each and every day count, and make sure you put forth all of the energy you need to pass this test, then you will eventually get there.


Best of luck to you all!

Dr. Paul

Leave a Reply