How I Studied For The USMLE.

IMG_6072 2.PNGMost IMG/FMGs that I meet want to know how to prepare for the big boards. I often get questions regarding my experience with the USMLE (United States Medical Licensure Exam) and for tips and advice..

I prefer to speak with these students on a 1:1 basis because there is no cookie cutter formula and studying should be tailored to individual abilities and needs. This is a challenging test and it shouldn’t be taken lightly. Preparation must begin early. In the case of the IMG/FMG, it should begin on the first day of medical school.

Either way, I will try to be as brief as possible in writing. This should not serve as your gold standard. Depending on how much you truly learned in medical school your plan could differ slightly from this one.

What I do know is that THIS method worked for ME.

How? You may ask …

The evidence: a several point increase in my score on step 2 compared to step 1.

If I could go back in time I would have applied the method I used to get a 240 on step 2 to my step 1 study plan.

THIS METHOD is what I will focus on sharing within this post.

The lonely score on step 1 already happened for me, but it doesn’t have to be the case for you! It got me where I needed to be but that was also 6 years ago and testing standards have changed over the previous years. Residency positions have grown to be increasingly competitive.

All you have to do is heed to valid advice and follow it diligently for you to see the evidence in your life and board scores.

If what you have been doing is not working, try this instead. Insanity is trying the same thing over and over and expecting a different result.

I will begin by listing the resources I used. (note: This post is not sponsored by any of these resources/authors/publishers) :

  1. Question Banks
  2. Videos/ Audios
  3. Recommended Text Books by your school
  4. First Aid (review book)
  5. Master The Boards step 2 (review book)

1. Question Banks
I primarily focused on the USMLEWORLD q bank, and I started preparing for the step 2 at the beginning of my 3rd year. Notice I did not start studying specifically for the test a few weeks ahead.  Again, start early. Kaplan questions also came in handy but only after I had completed USMLE world three (3) times.
Recommendation: Do USMLE world questions. Always in timed mode. The timed mode allows you to begin to build the tenacity of sitting still through the exam. It trains you to read and understand the questions in the allotted time frame and that is what truly replicates test day. You can consider tutor mode on slower study days as well but again I recommend timed test mode as much as possible.

You will get accustomed to the real test with timed mode. Start by doing a minimum of 1 block a day (in timed mode) when you’re several months away from the test date. If you are less than 2 months out then that should be 3-4 blocks a day. Or more.

It isn’t simply about doing questions to get them correct, the goal of these daily blocks is to learn NEW CONCEPTS from within the answer stem, explanation and educational objective of each question. This is where videos/audios or text books come into place as well as to supplement knowledge during the Q bank review.

Remember to mark complex questions as you go along the timed block so you can review it at the end of the current block.

Questions banks should not be memorized. You don’t need to cram all the educational objectives, the USMLE never runs out of a thousand ways to test you on the same concept. That’s how medicine works, this is a basic life principle. You will be tested on the same concept in several different ways. If you do not learn the concepts behind the question you may end up taking the test a few times. This is bad.

2. Audios/Videos

During your first round of going through UWorld, you will need this the most. So it may take longer to go through videos than it does QBanks.

After completing your block of questions in timed mode, you’ll need to end and review the test. Begin the question review by revising the questions that you got incorrect. You should read through the stem of the question while asking yourself a challenging question such as “what concept should I be learning from this question”, “why did I misunderstand this question” etc …

Such thought forming processes will help you properly revise the concept you’re lacking knowledge in. This is where you will need videos/audios to explain these concepts in great detail. I think of video/audio resources as a way to facilitate your understanding when someone with expertise explains a concept to you.

Audios incorporate passive learning which can be done while you participate in extracurricular activities or house chore time.

I used Kaplan videos in 2009 and 2010 for the most part, and Goljan audios (and high yield notes) as well. Other more popular and in-depth resources now include DIT (doctors in training), Pathoma for Step 1 etc. Pick whatever works for you! Simply ensure you are learning with it. Talk to those directly ahead of you in medical school at this time to find out what resources they have found to be most helpful. Most of my students today recommend Pathoma.

3. Text Books.

Text books are detail oriented and should be go-to for material that wasn’t properly taught in medical school. You should use them also for material not previously well understood or forgotten. I still use my text books as an attending today, so go figure!

Review books, on the other hand, are made for RE-VIEW (definition: to study or look at something again). In order to use a review book or review note, you need to have properly studied the concept before. This is why I recommend review books should be utilized during the final study phase, so in the last few weeks prior to the test. Annotations during the question bank review can be done into the first aid. What I found is that sometimes that space isn’t enough, so save it for high yield concepts and use a notebook instead. Writing reinforces material into your memory anyway. Also, do not review other people’s notes. The author is more likely to have fully understood and can explain the concept without referring to their notes. This is where you want to be. So you should create your own review notes. The other benefit of writing into a note book is that you can review material during your down time/train ride/bed time etc. Writing out what you learn is a great way to reinforce material into your memory.


One last suggestion: You should be able to successfully score 80% or more on your Q banks prior to taking the USMLE. This is a safety net score range. Also, always do at least 1- 3 NBME forms to assess your standard at any given time. Your NBME score 2 weeks prior to the test should reflect what you would get if you took the test at that time. So,  definitely, higher is better. Never sit for the USMLE after a crappy or poor NBME; this is a set up for failure. Signs like these should be heeded to! Never ignore the writing on the wall.


In a previous post, I discussed active versus passive learning. Active learning is what is necessary for the most part. Click here to be directed to that article. Passive learning comes into play towards the end of your study period. I write these things so that you can hopefully perform better than you think you can. I hope this helps you in one way.

Leave a question below and I will be sure to respond.

Dr. Lum.

4 Comments

  1. Esther oben
    08/28/2017 / 1:39 pm

    Thank u so much Dr Lum for such a detail strategy into studying. Question banks are def my go to now and ur right, videos really explain the concepts so well. Personally finished all the Kaplan n pathoma vidoes then dived ino uworld. Gave me an idea on most concepts. How long did it use to take u to go
    through one block of uworld?

    • ninotswalk
      Author
      08/28/2017 / 2:48 pm

      I believe it was an hour per block. So I used the timed mode and it defaults your test to 60minutes. There are 46 questions per block on the real test. I tried to complete each block within the allotted time frame. On the test day You don’t want to leave any questions unanswered so try to answer all 46 questions during the allotted time of 60 minutes now. This way on test day you’re very familiar with the speed, steadiness and agility to go through all this.

  2. Monika Carl
    08/08/2019 / 3:15 pm

    Wow. First I must say a very big thank you to you for doing what you do. After going through This article I now feel that making it for the USMLE is very very possible. There have been a rekindling of the Fire. Thank you so much doctor.

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