How to Prepare for the USMLE Exam

  It should be considered as a positive that the field of professional medicine is so difficult to get into. After all, something as important as the study of the human body and all of the different ways it can fail on us should only be practiced by the most dedicated and qualified individuals. It’s because of this fact that becoming a licensed medical professional is blocked by such high barriers of entry, and it’s also why these positions pay so highly.   But what are these barriers of entry?   In addition to medical school, all aspiring physicians must pass a rigorous licensing exam before being legally allowed to practice medicine in the United States. This exam is taken in three parts and is referred to as the United States Medical Licensing Examination, or the USMLE for short. For the most part, this exam is meant to evaluate the student’s understanding of their med school curriculum, which is why the pass rates are high.   However, just because the USMLE pass rates are very high, it doesn’t mean that it’s easy. Passing this exam will require a tremendous amount of effort and expertise. Fortunately, we’ve assembled this comprehensive guide on preparing for the exam to help you get through this substantial ordeal. Everything is covered in this article, from the typical costs and dates of the exam to tips on how best to prepare for it.   Keep reading to learn more important information about the USMLE:

USMLE Content

As it is meant to be taken alongside a student’s medical school career, the USMLE is made up of three Steps that are taken at different stages in their education. For the purpose of clarity, here is some brief information about the contents of each Step.

Step 1

Step 1 of the USMLE is a one-day test with just under 300 questions. This portion of the exam tests the student’s knowledge of the sciences as they relate to professional medicine, such as anatomy, physiology, pharmacology, and others. Due to the size of this step and the vast amount of content covered, many consider it to be the hardest of the three steps.

Step 2

Step 2 of the USMLE is divided into two subsections, labeled as Step 2 CK and Step 2 CS. Step 2 CK covers clinical knowledge and is another one-day exam with around 300 questions. Step 2 CS covers clinical skills and involves simulated encounters with patients while under supervision.

Step 3

Step 3 of the USMLE is a two-day exam, with around 230 multiple choice questions on the first day and 180 on the second. This final step of the exam tests the student’s ability to practice medicine without supervision through hypothetical patient scenarios.

USMLE Scheduling

The three steps that make up the USMLE are meant to be taken at different times in a student’s med school career. The idea behind this is that each stage of the exam evaluates different areas of medical knowledge that they will learn about in specific years of their enrollment. This aspect of the exam can make scheduling tricky.   For starters, enrolling in different steps of the exam will need to be done at certain times in order to secure an exam date. The first two steps of this exam are handled by the National Board of Medical Examiners, or the NBME for short, with Step 1 usually scheduled during a student’s second year and Step 2 during the fourth year. Step 3 of the exam is regulated through the Federation of State Medical Boards (FSMB), and is normally scheduled after the student has graduated med school during their first year of residency.   Scheduling for all 3 steps of the exam can be done in three month periods of time, referred to by the NBME and FSMB as eligibility windows. For a given calendar year, these eligibility periods usually start around November of the prior year and end on December 31st. Once a student has scheduled their exam and paid the fee in one of these periods, an appointment is set some time in the subsequent 12 months. Students can reschedule their exam dates within this eligibility period or request a 3-month extension, but this will usually require paying a rescheduling fee.   Speaking of fees, the next barrier of entry into professional medicine is the substantial costs associated with the USMLE. More information on that can be found below:

USMLE Costs

In much the same way that the USMLE requires a substantial amount of effort and energy from students, it also comes at a tremendous financial cost. Each step of the exam comes with a fee that needs to be paid during the scheduling process, and attempts to reschedule a student’s exam date can also accrue additional fees.   According to the NBME’s website, the initial cost to enroll in Step 1 and Step 2 CK for 2018 is just over $600. Keep in mind that this is the cost for each step, not the combined cost for both. The second portion of Step 2, known as Step 2 CS, costs more than double this rate at almost $1300. According to the FSMB’s website, Step 3 will cost $850 in exam fees. The most important thing to understand about the USMLE is that these costs increase every year by small increments. Because of this fact, students interested in taking the USMLE will want to do so sooner rather than later in order to avoid spending more money.   After reading this information on exam fees, some students might be wondering: Why does Step 2 CS cost so much more than the other steps?   The reason for this increased cost is because Step 2 CS requires hands-on testing with live patients in a supervised environment. The resources required to set up this testing process are greater than the other steps, which are mostly written, thus justifying the increased cost.

Studying for the USMLE

With the knowledge into how the USMLE is structured, scheduled, and paid for, the next step for any student looking to pass this exam is developing a solid study plan. While there isn’t one universal study plan that is guaranteed to work for every student, there are some effective strategies students can try, as well as some common pitfalls to avoid. First off make sure you have the best USMLE prep course!   That said, here are some do’s and dont’s that will help prepare anyone to CRUSH the USMLE!

Do: Identify Your Learning Strengths

Modern psychological thought has led to the theory that humans learn in many different ways. An individual can be more effective at one method of learning than others, which is referred to as a different kind of intelligence. This theory explains why some people are better musicians than others, or better painters, or better writers.   A student organizing their study plan for the USMLE would benefit greatly from identifying their learning strengths and adopting a strategy that revolves around it. For example, someone who is a strong visual learner will want to study and create graphs and charts. An auditory learner will want to listen to lectures, and an interpersonal learner will want to form a study group.   Try filling out this free online questionnaire to determine your own learning strengths!

Don’t: Stay Up All Night Studying

It’s common to find students staying up until the wee hours of the morning studying for their exams in college. And while burning the midnight oil may seem like an effective use of a student’s time, the truth is that this practice can do more harm than good.   The human brain needs regularly scheduled sleep to process the information from the day prior. In order to actually retain any information gained through daytime studying, a good night’s sleep is vital. Be sure to sleep for as long as your body needs it, even if you didn’t get enough studying done that day. What’s worse: studying for 10 hours and remembering it all, or studying for 20 hours and forgetting it the next week?

Do: Use Mnemonics

The USMLE is taken at a Prometric test center. This is a heavily controlled environment that features tight security; no test material is allowed to leave the exam environment, and no study material is allowed to enter it. This means that students are unable to bring cheat sheets or crib notes to the exam.   Because of this, memorization is key to getting a passing grade on the exam. Flashcards can be an effective way to memorize certain concepts, but an even more effective method involves mnemonics. Also known as mnemonic devices, these are rhymes and techniques people have used for centuries to trick their brains into remembering complex information.   A famous mnemonic device is often taught in elementary school to help math students remember the order of operations. PEMDAS is an acronym that stands for Parentheses, Exponents, Multiplication, Division, Addition, and Subtraction, but it can also stand for Please Excuse My Dear Aunt Sally. Coming up with a few mnemonics like these can easily condense complicated information into easily memorizable chunks.

Don’t: Study in a Distracting Space

In order to avoid needing to stay up late when studying for the USMLE, it’s important to study in a distraction-free environment. For students, it’s a bad idea to study in their dining commons or dorm room; these are environments that can have people coming and going constantly while making loud noises. Instead, try studying in a secluded part of the school library where there’s likely to be less noise and visitors.   When studying at home, stay away from any beds or TVs. The temptation to take a nap or channel surf can be overpowering, especially when studying alone since no one will be there to hold you accountable. Instead, study in an environment with a table and chair that necessitates standing up straight, ideally with a lot of natural light and some fresh air.

Do: Eat and Drink Healthy

The human body is an extremely complex machine made up of several smaller machines. Everything is connected, and the food you put in your stomach can have a tremendous effect on the way your brain functions. Because of this, a proper diet with essential vitamins and minerals will vastly increase the effectiveness of your study sessions.   Try to eat a lot of fish, whole wheats, and cruciferous vegetables. The fish contains high amounts of Omega-3 fatty acids, which are essential for proper mental functionality and cannot be created inside the human body. Whole grains contain complex carbohydrates that supply energy and increase mental acuity. Leafy green vegetables such as broccoli, spinach, and kale contain high amounts of Vitamin K and B vitamins, which are important for improving memory and alertness. In between meals, snack on dark chocolate for antioxidants and mixed nuts for more Omega-3’s.

Don’t: Cram at the Last Minute

It may be tempting to spend the last day before the exam cramming until the very last minute. After all, if the research and studying is done right before the test, it should all be fresh in your mind, right?   Well, not exactly. Here’s why that’s a bad idea:   Remember what we said earlier about sleep and memory? The brain needs time to process any new information and transfer it from your short-term memory to your long-term memory. This means that the likelihood of you remembering anything that you learned right before the test is slim to none. You can try this free online short-term memory test to see for yourself.   A much better way to spend your last day before the exam is by relaxing. If you’ve done a good job studying in the weeks and months leading up to the exam, supplemented by a proper diet and regular sleep, then you should have nothing to worry about. Instead, take some time to decompress and shake away any nagging nerves. This will have a significantly greater effect on your exam results than a last-minute cram session.

Conclusion

The USMLE is just one of the many intimidating barriers of entry for an aspiring medical professional. However, what’s important to understand about these barrier is that they are designed to be overcome. Anyone who has the dedication and willpower to become a physician, surgeon, or any kind of medical professional can successfully pass the USMLE and all other obstacles in their way.   Hopefully this article was helpful in your journey to an exciting and rewarding career in medicine. Now get out there and CRUSH the USMLE!

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