Preparing for Step One
USMLE Step 1 is a multiple-choice questions exam for basic science knowledge according to general principles and individual organ systems.
Step 1 consists of one day eight-hour testing session with 350 questions, divided into 7 blocks of 60 min each block. The exam is split into a variety of disciplines, similar to the curriculum of most medical schools.
The basic disciiplines include topics in (the NBME uses different words to describe the topics, but the topics fall into these descriptions): biochemsitry and molecular biology, cell biology, genetics and development, pathology, psychiatry, physiology, pharmacology, microbiology, immunology, and statistics.
The NBME further specifies the topics to be tested within physiology, including systems biology (neurobiology, immunology, general physiology, etc.). There is only one question format for USMLE Step 1: "Single question best answer".
The best way to prepare the USMLE Step 1 is to learn the information well during each course so that as you prepare for the boards you are reviewing, not re-learning!
Several things have been proven to help students prepare to do their best of Step 1:
Learn the Material you are Currently Studying in Your Classes
Approximately 70% of the questions on the exam are likely to use or combine information in ways that you may have not seen before. One purpose of Step 1 is to see how adept you are at taking partial information and, based on that, figuring out an answer you consider a high probability response. You can't do that with MEMORIZED material, but you can do it using material that you have LEARNED.
Know How to Approach Multiple Choice Questions and Practice
There are skills that you can learn to help you answer these kinds of test questions. Here's how Kaplan recommends approaching vignette styled multiple choice questions:
- assemble key clues into a mental "snapshot" of the patient.
- understand precisely what is being asked
- allow a few moments to think, recall, and to anticipate possible answers
- compare the given choices to your anticipated answer
- mark choices that match best
- rule out choices that don't account for all findings
- mark the best answer
Kaplan's experts say that people who are bad at multiple choice questions focus on the choices rather than the stems of the questions. This is a very inefficient approach and one that tends to result in more mistakes. Those who are good at multiple choice questions focus on the stems, not the choices.
Allow Enough Time to Prepare, But Not too Much
Make a Study Schedule and Stick to It
This is a critical step in successful Step 1 preparation.
Spending 10 hours a day passively reading study guides or old notes is much less effective than spending half that amount of time in active study. Explain concepts out loud to a study partner, practice answering questions by explaining why the right answers are right and the wrong answers are wrong. If concept mapping works for you, do it. If there are other methods that work for you, use them.
Other Step One Advice
Dr. Judy Schwenker, Kaplan's Curriculum Director, discussed how Step 1 is similar to medical practice:
- You must find key information
- The information you need may be buried
- There are distractions
- There is time pressure
- You must use probabilities to make decisions
- You'll never know it all
- Situations won't exactly fit what you've learned
Dr. Schwenker also mentioned the most common mistakes when preparing for Step 1:
- Passive studying
- Insufficient practice with questions
- Memorizing, not understanding the material
- Inappropriate test day strategies
- Misreading or misinterpreting questions