USMLE Step 1 is the most important exam we have to take in medical school. Before starting at AUA, I had never heard of it. I remember being at Orientation and hearing Dr. Glasser talk about this “monster” exam and thinking, “there’s no way an exam harder than MCAT exists!”  As each semester passed, I learned more about the exam, but never understood its significance until one day every professor was on cloud nine; they had just received word of students scoring in the 90’s on their USMLE Step 1. Several semesters later I became one of the students of whom the professors were so proud.

How does one prepare for success on Step 1? Start from the 1st semester with good study habits, understanding concepts, not memorizing questions, and focusing on weaknesses and supplementing strengths. Preclinical Sciences is the learning foundation and the time to experiment with study strategies in a quest to find the right one to serve its purpose of lifelong learning. Each shelf exam is USMLE preparation – these are retired USMLE questions. Preparation after 4th semester should largely be a review of difficult concepts. This timeline is variable, depending on the strength of a person’s knowledge foundation. Do not feel discouraged if your timeline takes longer than classmates – compete with yourself to improve, not with others.  Some people like review courses. I did not participate in any because I preferred self-directed learning. If you need external motivation, review courses may be for you.

After passing my exam, I posted a review of my study strategies and materials. Don’t neglect any subjects in your review, especially the strong ones – the goal should be to maximize points overall.  Whether you are a self-directed or classroom learner, the most important part of USMLE Step 1 preparation is doing practice questions. This has a 2-fold effect: first it exposes you to a broader perspective on the exam topics.  If you practice deconstructing questions and understand what is being tested, you will not be surprised on the exam.  Second, USMLE is a mental marathon.  The brain must be conditioned to remain Alert & Oriented x3 during the 8 hour day. Practicing questions in exam simulation mode will help with this and limit mental fatigue on the real test day.

Sleep & nutrition are important. Eat well-balanced meals with lots of fruit as snacks and try to avoid high-calorie energy drinks which can cause you to crash later. The day before the exam, try to relax and get as much sleep as possible. Relaxing in the face of such an important exam may be easier said than done but keep a positive attitude, and remember if you worked hard you will reap the benefits!

by Jasmine Riviere Marcelin, Class of 2011