Test Taking Strategies: how to maximize your score

Your USMLE step 1 and step 2 scores are the most important pieces of information in your residency application. However, acing your board exams isn’t just about knowing the science but also about having strong test taking skills. At the end of the day, your score is a combination of how smart you are multiplied by how hard you work divided by your test taking skills. Here are my test taking strategies to maximize your score on test day.

 

Find your weaknesses

It’s hard to improve your test taking skills if you don’t know where to start. So do a question set of UWorld or two and while you are reviewing your answers figure out why you got the question wrong in the first place. In my mind, there are two broad categories of why you get questions wrong. The first is that you straight up didn’t know the answer because you didn’t know the science or medicine behind the question at hand. The second category of incorrect answers is due to poor test taking skills.  So if you get a question wrong because you didn’t remember the auto-antibody that correlates with autoimmune hepatitis then don’t stress out about it. Just go study that subject material. However, did you fluster over this answer choice for five minutes? Did you eat up all of your time trying to remember the answer? That’s a test taking strategy and is something you have to work on.

So first, (1) figure out if you got the answer wrong because of a lack of knowledge versus poor test taking skills. Next, (2) continue to jot down the reasons why you got these questions wrong. Eventually, you might (3) find patterns in why you get questions wrong.

 

Recognize patterns concerning why you are getting questions wrong

So at this point you should have completed a few question sets and collected some data concerning why you are getting questions wrong. Maybe you are a great test taker and you just need to study the science a little more. If that’s you then stop reading this blog post and go study! If you’re like me, you might need to make a plan moving forward concerning how to improve your test taking skills. Some reasons why I got questions wrong in the past were because:

  1. I wasted time on ‘easy’ questions and had to rush through questions near the end
  2. I changed my answer choices
  3. I would be thinking about question number 1 while I was reading question number 2
  4. Test taking anxiety
  5. Stupid mistakes

Next, I will go into how I overcame these test taking weaknesses of mine and hopefully you can mimic what I did and overcome your deficiencies.

 

Overcome minor anxiety by simulating test day

A soccer coach I once knew used to hate when we took practice shots from a stand still. He felt that during a game you rarely had the opportunity to take a shot when the ball wasn’t already moving. It didn’t simulate the game realistically. Likewise, you need to prepare for the exam by answering practice questions against the clock. It will simulate the anxiety of test day and, hopefully, make you more comfortable when answering questions in the hot seat. This helped me get over my minor test taking anxiety. Those butterflies in my stomach.

Power poses are also a great subconscious confidence booster. Long story short, if you have positive, confident posture it will translate into a slight increase in real life confidence. That goes for test day too. Check out this TED talk that goes into more depth on the topic.

As an aside, this post is mainly for test taking strategies. Minor tweaks that can improve your score. Which means that if you have severe anxiety to the point where it is truly inhibiting your ability to take tests then please seek professional help. There is no shame in speaking to a psychiatrist about your test taking anxiety and they are much better equipped to help you flourish come test day. Same thing goes for people whose attention span could use a little artificial endurance.

 

Don’t overthink it and stop changing your answer choices

I recently tried this new ice-cream place in Brooklyn called Ample Hills Creamery (if you live in the area you NEED to go there). Looking at the menu I instantly saw the words ‘Salted Crack Caramel’ and knew what I wanted to try. Except then I saw other delicious looking options like ‘The Munchies’ and ‘Mexican Hot Chocolate’ and I started second-guessing myself even though I knew what I wanted to get. Likewise, when it comes to test day don’t overthink your answer choice. If you think you know the answer then click the bubble and move on to the next one. JUST CLICK THE BUBBLE AND MOVE ONE! Your first inclination is often your best guess…especially if you aren’t sure why you think it’s the correct answer choice (sometimes your gut is smarter than you and not just with regards to ice-cream).

UWorld also has a great tool to see where you are making your mistakes. I found that I had a greater number of answers that I changed from correct to incorrect that the other way round. By making a ‘click and move on’ rule I increased the number of questions I got right. It might only get you one or two questions right in each question set but they add up quickly. Especially when step 1 and step 2 are 7 and 8 question sets long respectively.

The only exception to this rule is if I went back to my question and found that I completely missed something. Oh, the patient had a myocardial infarction because he did cocaine! I’m gonna change my answer from beta-blocker to calcium channel blocker. Boom. Science bitch!

 

Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth

There were a lot of easy questions on step 2. Things that everyone gets right like ‘give IV fluids’ or ‘compare to old chest x-ray’. Then there are the cluster of questions that make me wonder if I forgot everything or if I just straight up never learned it. For example, on step 1 I remember a question on neurofibromatosis type I but I forgot that it is also often called von Recklinghausen Disease. At the time, I wasn’t sure if von Recklinghausen Disease was the same thing as neurofibromatosis type I or not. Instead of ruling IN the correct answer I simply ruled OUT the incorrect ones. With this approach I was left with only one possible answer choice and ended up picking the right one.

Ultimately, this isn’t anything new or groundbreaking that you haven’t heard before but its worth hearing again. When it comes to these standardized tests every question is worth an equal number of points. I hope that these test taking tips will help you get a few more questions right and help bump up your score because every little bit counts. Happy studying!

My Three Favorite Study Aids That Every Medical Student Should Have

Besides caffeine, there are three study aids that got me through medical school. These resources speed up the memorization process, enhance your learning for long-term retention, and help you understand the required mountain of material you learn during the first two years of med school. They were my favorite resources to use during the basic science courses and while I studied for step one. The more I found myself using them the more useful they became. As I’ve written about before, don’t half ass anything– and that includes your study aids. So try these out, see if they help you, and then commit to using them. Without further ado, here are my three favorite med school study tools…you know, besides note cards of course:

First Aid for the USMLE Step One

This is every medical student’s bible. If you ask a med student studying for step one, ‘if your house was on fire and you were only allowed to retrieve one item’, their First Aid book would be the answer. If you are about to start med school just go ahead and buy it. This book provides a backbone outline of your medical education and its up to you to fill in the details. You can almost always tell the first semester students apart from the fourth semesters based on how much white space is left on the pages of their First Aid book. Just remember, post-it notes are your friends, don’t use ink that will run, highlight in moderation, write small but legibly, and always double-check to see if the information you are about to scribble in your book isn’t already there.

Picmonic

Imagine that instead of forcing yourself to memorize every bug, drug, syndrome, system, and tumor that you could just watch cartoons and all the information would just magically diffuse into your consciousness. Picmonic is as close at it comes. Instead of just listing information and letting you figure out how to inject the information into your brain, Picmonic provides you with tons of notecard sized cartoon illustrations that tell unique and memorable stories. Each cartoon represents vital information about the subject at hand. With pathognomonic pictures and rhyming raps about almost everything that med students need to memorize and differentiate between, Picmonic makes memorizing the minutia of med school both easy and fun. I seriously would not have made it through med school without it.

*Use my link to get 30% off your Picmonic subscription!*

Pathoma

The only thing worse than not being able to pronounce the diseases you are studying is not being able to understand your professor teaching you. Whether your professor has a thick accent or is just a terrible teacher, Pathoma is the answer to your troubles. It’s the gold standard when it comes to studying pathology. The textbook has clear illustrations and descriptions of every disease process you learn about in the first two years of medical school and the accompanying videos explain the pathophysiology in a clear and concise manner. I honestly don’t know a single med friend of mine who doesn’t use it.

From The Final To The Finale

Let’s take a look at your schedule for the next month. You just took your last mini at Ross and all that separates you from freedom is your CCSB exam, your fourth semester final, and the comp. Then you can finally go home and study for the step! Sounds amazing- I know. Just think of how awesome it’s going to feel when you answer that last multiple-choice question of step one. You’ll be free!

Now before you begin fantasizing about what you’re going to do after you take the step (you’ll have so much more time for activities!) let’s talk about your study timeline starting from the day you take your fourth semester final leading up to your step. I tried to whittle down my thoughts into a few succinct points with the help of a few guest perspectives.

 

Recharge Your Batteries After Your Final

Some of my classmates were in C4 studying for the comp the day after our fourth semester final- I was not one of them. And if you are the type of person who will be in class the day after your final then this post may not be for you.

For everyone else, go do whatever it is that you want to do- treat yourself! Climb Mt. Diablotin, hike to Sulfur Springs, close out Tulips, lay on the beach, or stay inside with the air-conditioner on blast and marathon watch Grey’s Anatomy (I’m only on season eight- ruin it for me and we’ll have problems!). You are going to be studying almost non-stop for the comp and then keep it up when you go home to study for the step. So relaxing, centering yourself, and making sure you are ready for the long haul is priority number one.

 

Start With A Diagnostic Test

After you take into account the random days off that you are likely going to take, you only have about three solid weeks of studying before the comp. Now assuming you somewhat remember the stuff you just took a final on, you might not need to review absolutely everything before the comp. And quite frankly, you won’t have enough time to review everything. That’s why you need to triage the subjects and organ systems and make a study strategy for the comp. And you can’t make a study strategy without knowing what you actually need to focus on. So before you begin studying, get situated in your favorite cube (shout out to E-07!) and take a diagnostic test.

Use it to see where you strengths and weaknesses are. My best piece of advice is to guess which organ systems and subject areas you think you are strongest/weakest in and see how your guesses match up with your results. You might be surprised…or completely spot on!

Now I don’t think you can study everything effectively before the comp. Personally, I did very little for the organ systems that were on the fourth semester final. I focused on third semester organ systems as well as the basics from the first two semesters. I didn’t even touch the respiratory system. But you have to look at the comp as a stepping-stone and not the end goal- step one is the end goal. You can always go back to stuff you skipped after you pass the comp.

 

Put In The Work And Pass The Comp

I firmly believe that the comp is beatable if you put in the work. Most of my friends who failed the comp admit that they simply didn’t study very hard for it. And failing the comp isn’t a big deal. You simply have to take it again and pass before you take the step but it definitely messes with your timeline and possibly your confidence.

I interviewed a close friend of mine who failed the comp. After passing fourth semester he met someone on the island and started ‘reviewing a lot of anatomy’. His only goal for approaching the comp was to attempt to attend Becker everyday and nothing else. And even that simple goal didn’t always get reached.

On two occasions, he even skipped Sunday lectures to attend brunch at Champs knowing that he wouldn’t be seeing those two days of material. He didn’t touch DIT, Kaplan videos, and only did seven UWorld questions. And he only missed passing the comp by four percent- roughly eight questions.

The comp is beatable but you need to put in the work. If you study for it like it’s the step then you should have no problem passing. As the old idiom goes, if you fail to prepare then you prepare to fail.

 

Don’t Stop

An object in motion stays in motion. The same is true with regards to studying. The hardest part about studying is often getting started and getting into a regular routine. When you go home after you take the comp you are likely going to take some time off again before you get back into studying. You’ll be home- enjoy it. Hang out with your family & friends, go get drunk in the city, join a gym- whatever floats your boat. Just don’t take too much time off because once you taste the sweet flavor of freedom you won’t want to go back to that dreary library.

To hammer this point home, imagine taking your first semester anatomy practical exam all over again as a fourth semester. I know I just made some of you cringe at the idea but be honest with yourself- how do you think you would do? I’m sure that as a first semester who was seeing non-stop anatomy everyday that you would have done great! However, as a fourth semester you might not remember the exact presentation of an ulnar nerve injury at the elbow versus the wrist.  Or what nerve roots make up the nerve that runs with the profunda brachii that may be damaged in a mid humeral shaft fracture. My point is that if you are studying for the comp everyday for three weeks that you shouldn’t let it go to waste. All of that medicine is going to be at the forefront of your brain. Keep it there and just keep going or else you may as well start over.

 

Multiple Choice Questions

By the time you take step one you should have fully completed at least one question bank. Personally, I believe four thousand is a good goal (though I only got to 3K). That’s a lot of questions and you need to incorporate MCQs into your daily routine as soon as possible. Do you bike at the gym? Do ten behavioral questions. Waiting for friends at the bar? Do five biochemistry questions. Do multiple-choice questions? Do multiple-choice questions!

My favorite routine was studying in the morning for four hours and then doing two sets of forty-six questions and then reviewing the answer choices after I got back from the gym. Granted, this was when I was in full power turbo study mode…but it’s totally doable. Just find your balance, set a goal, and go for it!

 

Don’t Do Half Of Anything

My dilemma when I started studying for the comp was knowing which resources to use- specifically Doctors In Training or Becker. I began flip-flopping between the two. I watched half a day’s worth of lectures on DIT and half a days worth of Becker lectures and both ended up suffering.

Choosing which resource you are going to use is a tough decision and one that shouldn’t be made lightly but stick with one once you make a choice. I knew that I couldn’t get through all of DIT before the comp so I chose to do Becker. One of my friends did all of DIT before the comp and did it all over again for the step. Weigh your options, pick one, and don’t look back.

 

To Becker Or Not To Becker?

By the time fourth semester had come around I had heard conflicting opinions about the Becker review course but overall I think anyone who used Becker had a good experience with them.

I liked Becker because it gave us a different perspective on the same material we already learned. Behavioral was amazing. I finally understood the intricate differences between all the self-defense mechanisms, personality disorders, and all of the statistics. Go to the behavioral lectures even if you don’t do anything else with Becker. And the other subjects they covered were also my biggest weaknesses that turned into strengths (i.e. pharmacology, physiology).

My friend Kristyn used Becker for the comp. She was extremely exhausted after passing fourth and decided to take a week off to relax and regroup. She told me that, ‘although I didn’t take the comp as seriously as maybe one should, my honest end goal was to just pass the comp and get it out of the way so I could start step studying once I got home’. She continued, saying that ‘for the comp, I decided to mediasite the Becker lectures at Ross and read First Aid for the subjects Becker didn’t cover and in the end it was enough to pass and get off the island’.

So should you use Becker? Only you can tell for yourself. I suggest that you invest at least one day in using Becker and test it out for yourself.

 

In my next post, I’ll go into more detail about the step one Becker course that Kristyn signed up for and the Doctors In Training course that I used for my step studying along with other resources I found invaluable to my step studying (i.e. DIT vs. Becker, Kaplan vs. USMLE World question banks, Picmonic, Firecracker, etc.). I hope you found this post helpful and good luck on your final! As always, feel free to leave a comment, question, or any other feedback and I’ll get back to you as quick as a cat. Meow.

Preface

After passing step one, I’ve decided to write a series of posts that will encompass everything involved in studying for step one of the United States Medical Licensing Exam for fellow Ross University students. During my fourth semester on the island I felt lost in a sea of resources, conflicting study ideologies, and differing mindsets on how to approach studying for the comprehensive shelf exam…let alone the step. Thus, my study timeline that I will describe will begin with passing your fourth semester, studying for the comp, and extend until your step test day. My discussion on how to study for step one will include my guiding philosophy on how to approach studying for the exam, different study strategies, resources, and a few tangential but entertaining topics. My hope is to illuminate shades of confusion that plagued my studies while on the island and give current Ross students a little hindsight to make more informed decisions about their study strategy with even greater confidence.

As always, if you have a specific question or concern that you’d like me to address please post a comment below or hit me up directly on twitter via @MarcKittyKatz. Enjoy!