USMLE Step 1 Preparation: 3 Reasons Why Your Scores Aren’t Improving

Many students getting started with their USMLE Step 1 preparation fall into the trap of doing exactly what everyone around them says they should be doing, but often times that isn’t what’s best for them. Getting into a routine and doing only what your colleagues are doing is often times a cause of stagnating progress.

In today’s video, we’re going to talk about 3 of the big reasons why students hit a roadblock with their progress and see a lack of progress with their Step 1 preparation progress.

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If you’re not a fan of watching video, you can read the entire transcript below.

Reason #1 why your step 1 scores aren’t improving…

Poor factual recall.

This is very common amongst students, no matter what level of step 1 preparation they’re at, and for our first couple years in business, we saw this in almost every student who came through our doors.

As the years went by, we began to incorporate what we call ‘drill sessions’ into our curriculums, both in our step 1 live, step 1 online, and even step 2 cs programs, and what we noticed was that the more often we incorporated drill sessions into our curriculum, the better students were able to recall factual information and the faster they were able to navigate through usmle vignettes.

The reason why students were doing poorly when it came to recalling factual information was simply because often times they weren’t paying close enough attention to the details, rather focusing solely on concepts. Eventually, this leads you to stalling with your progress because facts really do matter on this exam. You can’t get by solely on having a strong conceptual knowledge.

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Here’s what you can do in order to boost your own factual recall…

The first step is to collect as many 1-line questions as you possibly can as you move through your studies, and then to have someone quiz you on these questions each and every day.

In our own Step 1 preparation programs, our team puts students through a series of drill sessions each and every day to ensure that students are constantly being exposed to high yield facts that tend to show up on the exam.

This does take additional time and effort, but as with anything in life, the more time and effort you put into something, especially something as important as this, the better your results are going to be, period.

If you don’t want to create fact based questions for yourselves, consider joining our online step 1 preparation program, because we’ve done all the hard work for you.

Reason #2 why your step 1 scores aren’t improving…

Poor Vignette Diagnostic Skills.

This is a problem that many students have and this really stems from the fact that the questions asked on the usmle exams are different from any type of question you’ve seen in the rest of your scholastic career.

On top of that, nobody is really going into detail about how to attack these questions or how to dissect them to improve your chances of eliminating those distractors and choosing the most correct option of the group.

Now, this one is not an easy fix, and that’s why we go into so much detail regarding how to improve your vignette dissection skills in all of our programs, but let me give you a couple of tips that you can begin to implement right away that should at least get you moving in the right direction and help you improve your ability to dissect vignettes….

Success Tip: Practice Vignette Dissection

Nobody, and i mean nobody, that myself or any of our team of physicians who work with our students have ever come across a student who dedicates time to learning how to read a question for comprehension…

No, what most students do is simply jump into questions and struggle right off the bat. And if this is you, trust me you’re not alone.

So the first thing you can do to help yourself here is to dedicate time to just reading through a vignette and trying to figure out what they’re asking you, without the added pressure of actually having to answer the question.

So what you’ll do is go through a vignette slowly and deliberately to try and figure out exactly what they want you to answer. Don’t really worry about actually answering the question, but rather practice highlighting information that helps you get to a conclusion about the vignette, and crossing out information that is put there solely as a distractor.

The better you become at doing this, the faster and easier it will be for you to figure out exactly what they’re asking of you when you start to dive into questions more seriously.

So as you highlight information and cross out non important information, start asking yourself what they’re asking you… for example, if the clues in the vignette are leading you towards something related to Turner syndrome, you want to identify this by choosing the information that helps you come to that conclusion.

Then, once you know whats being asked of you, you can look at the answer choices and see the specific question they have about Turner syndrome.

You see, the vignettes are like a puzzle…

You have to first put a few pieces together so that you can see the direction in which it is going, then once you’ve got a clear idea of what you’re looking at, it will make putting the rest of the pieces of the puzzle (ie. the answer) together much easier for you.

So that.s what you can do to improve… Practice dissecting questions to figure out what they’re hinting at or what they want you to recognize…

Don’t focus on the answering portion right away…

If you can first develop your ability to better recognize the direction they’re taking you in the vignette, then once you actually start to answer questions, you’ll find that it is much easier for you to accomplish that goal.

Reason #3 why your step 1 scores aren’t improving…

You’re doing the same thing over and over again.

What me and my team see again and again in students who come to us desperate to pass their exam after multiple failures, is that they failed once, then did the same thing to prepare the next time, and so on and so forth…

It is very important that you realize from the beginning stages of your preparation, that when you hit that wall and you’re no longer making improvements, that redoing the same thing again and again isn’t likely going to get you over that roadblock.

If you want to burst through a roadblock, you have to add something different to your approach.

If you’re reading the First Aid over and over again, and your NBME scores aren’t moving one bit, guess what, it’s because you’re doing the same thing again and again.

Instead, create a plan for studying in stages…

This means you might begin by doing a thorough review of everything, then taking an NBME and seeing where you’re still weak. Then doing a bunch of UW questions and seeing where you’ve improved, and so on and so forth.

If you take your NBME and you get a certain score, then just go back to doing exactly what you did before over and over again, you can expect that you’ll likely stall in your progress.

So, in order to either avoid this from the beginning or get yourself moving in the right direction if you’re currently facing a situation like this, you need to plan ahead so that you’re exposed to the information in different ways at different stages of your preparation.

You don’t want to only sit and read your materials quietly for the entirety of your preparation, as this will surely cause you to hit a roadblock.

Instead, you could plan to do quiet study, followed by answering questions, followed by holding tutoring sessions with your colleagues who are studying for the exam with you…

Of course that’s just an example, but the point is that if you’re hitting roadblocks or you feel like you’re stuck and not moving forward in the right direction, consider shaking things up and doing something different from what you were doing previously.

And there you have it… a list of what myself and my team have determined to be big reasons why students stop seeing improvements in their progress while studying for the step 1 exam. Keep these in mind as you proceed through your Step 1 preparation and you’ll find it easier to avoid roadblocks and/or overcome them if they show up.