Studying for Standardized Exams

Whether you’re a pre-med studying for the MCAT, a second year studying for Step 1, or a third year studying for shelves or Step 2, the same rules apply for any standardized exams. Standardized exams require two things: a little bit of background knowledge and a lot of practice.

Passive Studying: Building a Base

It’s essential to establish a foundation for the material you are studying. Upon this foundation, you can build your knowledge by doing practice questions; they will help you learn some of the details, and practice applying your knowledge.

There are countless resources out there to build this base. For the MCAT, there’s Kaplan, Examcrackers, among others. For Step 1, there’s the indomitable First Aid, [underrated] USMLE-Rx, [overrated] DIT, but perhaps your most important resource in building your foundation for Step 1 is mastering the material in your classes in medical school. You’ve probably heard it before, but I will say it again. If you do well in your classes, you are laying the foundation for success on Step 1. Learn the material right the first time, and when you get closer to your Step 1 study intensive period, you can focus on reviewing, rather than learning.

Pick your resources based on how you learn and your personal preferences. For the clinical years, if you prefer lectures, use a resource like OnlineMedEd which offers 15-25 minute lectures. If you prefer reading, use a resource like Step Up to Medicine for Internal Medicine, BRS Pediatrics for Pediatrics, NMS Surgery Casebook for Surgery, Case Files Obstetrics and Gynecology for OB/Gyn, First Aid for the Psychiatry Clerkship for Psychiatry. If you don’t intend on reading the above books cover to cover, the aforementioned resources should still be used as references to guide your studying and build your foundation.

Tip #1 To avoid getting inundated with resources, try picking one (or two, maximum) and sticking to it.

Active Studying: Practice, practice, practice

Once you have established a foundation, the next step is to pound practice questions. Practice questions are essential; if you are like me, you will retain medical knowledge much better by reinforcing it with practice questions, than by passively reading or watching lectures. Having said that, building a foundation is necessary to avoid getting every other practice question wrong; without a proper foundation, practice questions can be very intimidating.

Tip #2. Be careful of starting practice questions too early.

This occurred when I was studying for my Pediatrics shelf. Unlike OB/Gyn, Internal Medicine, Neurology, and Psychiatry, we never quite studied Pediatrics in the pre-clinical years. Sure, we learned about a few diseases here and there, largely in biochemistry, but we never had a dedicated Pediatrics class, the way we did for Neurology, OB/Gyn, all the IM disciplines, and Psychiatry. I thought my knowledge from my pre-clinical years would be sufficient for me to start doing practice questions as I built my base using resources like BRS Pediatrics and OnlineMedEd. After a few sets of UWorld, I was very quickly disabused of this illusion; I was scoring below the average on each question set, and getting more questions wrong than right. I put UWorld on hold, went back to the drawing board, and focused my efforts on establishing the foundation I had enjoyed with my other rotations. Once I finished building my base, I went back to UWorld, and my performance dramatically improved.

Tip #3 Don’t forget that question banks are primarily intended to be a learning tool, not an assessment tool. Try to look forward to getting practice questions wrong; it means you’re learning!

Striking a Balance: Active vs. Passive Studying

It’s essential to strike a balance between passive and active studying, between building your foundation and doing practice questions. I could literally spend an eternity just trying to establish a foundation, but it would be worthless without practice questions. It’s up to each individual, and each individual subject, to determine how much time you should invest in building your foundation versus doing practice questions. If I were studying for Step 1 again, I would limit the amount of time I spent doing passive things like DIT videos, and maximize the amount of time I spent pounding practice questions. My pre-clinical years have provided me with a sufficient base; reading through the high yield topics in First Aid would have been sufficient for brushing up on those areas I might have forgotten, or learning some of the details my medical school curriculum might have left out. If I could do it again, I would just do First Aid + practice questions.

On the other hand, when studying for shelf exams, it’s important to dedicate a decidedly larger proportion of your time to establishing that foundation. However you decide to manage your time, I try to maximize the amount of my time spent actively studying, which means minimizing the time spent passively studying.

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