USMLE Step 1 Journal: Reflections on my USMLE Step 1 experience

USMLE Step 1 experience!!
USMLE Step 1 Journal: Reflections on my USMLE Step 1 experience
Sketch Book May 21, 2017
As of Thursday, April 27 at 5:00 pm I am officially done with the USMLE STEP 1 exam! It has been 2 months since my last post. In that post, I discussed in detail my study plans for the two months leading up to the exam. In today’s post, I am going to walk you through my USMLE Step 1 experience and what I actually ended up doing and why that differed from my initial study plans. I’ll also share some USMLE Step 1 test day tips I found to be most useful, and reflect on how I prepared for the physically grueling aspects of test day.

usmle step 1 experience

In my last post, just two short months before the exam, I discussed my dedicated Step 1 study plans for those remaining two months. I was going to finish skimming through and reviewing each section of First Aid and then do ~160 questions from the UWorld Qbank per day (resting/reviewing SketchyMedical videos on weekends) until my exam date. This did not happen. As the saying goes, “Man plans, God laughs.”

My original plans got derailed for two reasons.

It took me longer to get through First Aid than I had planned, but I was okay taking that extra time. Going through First Aid in its entirety in four weeks was valuable to me because it allowed me to see the overlap between all the organ systems in a way that I could not when I went through them one at a time over the course of my 20-month preclinical curriculum.
Most importantly, after I finished First Aid and started UWorld questions, I saw that I was consistently falling short in pharmacology and microbiology, especially virology/parasitology/mycology, which I foolishly did not spend nearly as much time on as the bacteria when I took my microbiology course. I decided to do something about these consistent shortcomings.
At first, I was nervous to change my original USMLE Step 1 study plan. I had spent time researching and building that study plan. I had done the math to see how many questions I needed to do per day to meet a certain goal. I had even put it in my calendar day by day, hour by hour. It made me nervous to change things after so much planning.

usmle step 1 review

But then I thought of that adage: “Work smarter, not harder.” I’m sure that doing weeks of UWorld questions would have been helpful. It was certainly what the majority of my classmates were doing, and for this reason, I felt a lot of pressure to do the same. But just doing practice questions was not going to improve my weakest areas. So at that point, I took two of the three weeks I had left before my test and devoted myself to watching SketchyMicro and SketchyPharm videos, particularly focusing on my weak areas.

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I went through Parasites and Fungi in SketchyMicro, and most of SketchyPharm for the first time. I also took significant time to review Virology, which I had blown through at the end of my microbiology course in MS1. I left out the bacteria portion because I already had a pretty good handle on them.

Before my two weeks of dedicated studying focusing on SketchyMicro and SketchyPharm, I had been consistently scoring around the 60th percentile on my UWorld question blocks. Unfortunately, the USMLE folks do not publish percentiles that correlate with their scores, but according to an online calculator I found (not sure how accurate it is), this correlates to about a 230 on the actual test. After spending two weeks focusing on the SketchyMedical videos I mentioned above, I took a 4-hour long UWorld practice test. This was the Monday before my Thursday test. My estimated score on that test was a 243, which was only 2 points shy of my target score of 245. The important point here is that after my time focusing on my weakest sections, my score went up by around 10-15 points.

[Tweet “after my time focusing on my weakest sections, my score went up by around 10-15 points”]

The next day, I reviewed the sketches I had gone over for the last two weeks to help them stick. On Wednesday, the day before my test, I took the day off and went to the movies, spent time outside in my garden, and had a great dinner with my family. I finished that day feeling refreshed and ready for my USMLE Step 1.

Test day was a blur. I woke up early, drove to a coffee shop near the testing center, and spent a little time warming up my brain by reading. I got to the testing center 45 minutes before my test’s start time and was able to start 30 minutes early. Here are some things I found particularly useful.

Pack a full lunch, lots of snacks, and plenty of water. I had trail mixes, apples, chocolate (I told myself I need it for quick energy boosts), and a solid lunch of veggies and rice. I snacked and drank a couple mouthfuls of water after every block of questions, which kept me hydrated and energized without having to desperately fly through the end of a test block so I could go to the bathroom. These snack breaks (aka chocolate breaks) also gave me something to look forward to at the end of each block.
When your eyes and brain won’t focus on a question, take 10 seconds to pull your eyes off the computer screen and stare at something far away. Let your mind wander. I pulled this tip out of a Kaplan MCAT prep book and it has served me well on many tests since. It gives your eyes a little time to relax and take a break from that way-too-close computer screen.
Try to get two full nights of sleep the two nights leading up to your test. Don’t stay up cramming! It is way better to sacrifice those few things you would retain from your cram session, and instead, give your brain the rest and energy it will need to work through all that information you’ve been storing up over the last few weeks.
Take a practice test a few days before your real test. This will help shift you from study mode to test mode. And most importantly, it will give you a measure of how you will do on the exam. That knowledge gave me a lot of peace of mind in those few days before my test. Alternatively, if you don’t perform as well as you would have liked on the practice test, it will give you a little motivation to keep working hard until the day before your test.
Take a break and recharge before your test day! Before the MCAT, I took a whole week before my test where I looked at nothing MCAT-related. I just tried to relax and forget about it for a little while. By the time I got to the test, it felt like getting to hang out with an old friend that I hadn’t seen in a while… Or perhaps more accurately: rematch an old enemy. Before the USMLE STEP 1 exam, I took a whole day off and did things I enjoyed. I would definitely do this again. It recharged my spirit and mind after so many weeks dedicated to studying.
It’s only been a couple weeks since my test, so I don’t have my score back yet. And though I am certainly anxious to get that score, I do feel some measure of peace about the test and the way I prepared for it. I am glad I took the time to focus on my weaknesses. The jump in my practice test scores showed the benefit of that. I am glad I took the time to recharge, and that I packed snacks, took a break after every question block, and slept well before my test. Everyone’s study schedule and test will be different because every person is different. Hopefully, sharing my experience and knowledge has given you a better idea what you need to do to perform at your best on test day.
Best of luck.