Avoid These Common Pitfalls in USMLE Step 1 Preparation

5 Biggest Mistakes Students Make While Studying for USMLE Step 1

Neal Patel, MD/PhD Candidate

For many students, preparing for USMLE Step 1 feels like anything but a straightforward process. With dedicated study periods varying among medical schools and an array of available resources that seem to grow each year, medical students commonly feel unsure whether they are studying “the right way.” While there is no magic formula or single study schedule that works for every student, there are certain pitfalls to avoid along the way. Since I have seen many of the students I tutor fall into the same traps, I’d like to share the top five with you so you can avoid them while preparing for Step 1. Steer clear of these mistakes to improve your studying! 

1) Overloading on Resources

There are tons and tons of resources available for the USMLE, including flashcards, videos, and QBanks. This can lead to FOMO (fear of missing out), which can, in turn, lead to maladaptive behaviors like reorganizing a well-planned study schedule to accommodate a new resource and then falling behind on your main study goals. 

For both content review and QBanks, it is better to do an in-depth study of a few top resources than a surface-level review of many resources. A disciplined and thorough content review of only First Aid* and Pathoma is much better than going through many additional resources at only a surface level. Likewise, a careful completion of the UWorld Step 1 QBank is much better than a rushed review of two or more QBanks. Try building a plan with a fixed number of tried-and-true resources, and then stick to that plan. Keep it simple!

2) Speeding Through Your First Pass of UWorld

I see some students speed through their first pass of the UWorld QBank so that they have time to complete it the much-recommended “two times.” It’s debatable whether one pass is sufficient; my take is that the second pass of UWorld isn’t vital if students do well on their first one, study effectively, and learn from their mistakes. Rather than doing a full second pass, some students make flashcards for the topics they got wrong in the first pass. Then, after a consistent review of their flashcards, they do 40Q sets of the “incorrect” questions. Often, they get all the questions right the second time because they have now covered the challenging information so thoroughly. 

In brief, one near-perfect pass of UWorld is better than multiple less rigorous passes. However, if you finish your first pass of UWorld with a fair amount of time left before your exam, it is still beneficial to do a second pass of UWorld, emphasizing your missed and marked questions. This is especially true if you started early (perhaps using UWorld alongside your classes), and it’s been a while since you last completed the questions.

3) Spending Too Little or Too Much Time Reviewing Explanations

Finding the sweet spot for time spent reviewing each explanation can be difficult. Spending too little time can lead to missing key takeaway points while spending too much time can derail your entire study schedule. Although the sweet spot will differ for each student, it is crucial to discover how much time it takes you to perform an efficient but effective review.

The most common mistake I see students make is spending too much time once they’re in their dedicated study period. (Obviously, if you use UWorld alongside your M1/M2 classes, a more in-depth and leisurely review is understandable.) While this may sound counterintuitive, many students who are in their dedicated study period spend ten or more minutes reviewing each explanation. That is too long—it means 6½ hours checking each 40Q block! 

Once you have a solid foundation for questions to which you immediately knew the right answer and knew why the other answers were wrong, you should quickly review the explanation. This leaves more time for reviewing the explanations to more demanding questions, where you can search for new or challenging points to understand. If you’re still having trouble finding that sweet spot, try allotting double the time it takes you to do the questions. For example, for a one-hour 40Q UWorld block, which typically takes one hour to complete, plan to spend about two hours reviewing the explanations. 

4) Reviewing Only the Explanation and Not the Question

Part of the exam prep battle is developing good test-taking strategies. When reviewing explanations for questions you got wrong, it is tempting to focus only on knowledge gaps. However, it is equally important to understand whether something in your approach to the question (and not just a knowledge gap) contributed to your answering it incorrectly.

After you’ve reviewed the explanation, go back and check the question as well. This extra step will show whether additional information in the stem would have helped you correctly answer the question. If you find that you often miss critical clues in the stems, you may need to change how you approach the questions. Also, by reviewing the question prompts, you will start to see patterns—that certain topics are assessed in predictable ways.

5) Forgetting To Review Weak Areas Regularly

The amount of content covered in the USMLE can feel overwhelming at times, which causes many students to feel the need to go over all the material repeatedly, just to keep it all fresh. While repetition is helpful, a common mistake students make is spending equal time on their strong and weak areas. Instead, spend most of your time nailing down your weak topics, especially toward the end of your study period.

There are several strategies for focusing more study time on your weak points. One method that I have seen work well is creating a single flashcard for each fact, pathway, or principle you don’t know in a missed or marked question. Regularly going through the cards means you will frequently encounter your weak topics, so you can be confident you know the correct answer when the exam comes around. Another common strategy is routinely assessing your performance on different subjects within the QBank. If you seem to miss more questions on specific topics, you can tailor your content review and additional practice tests to these particular topics.I hope this article helps you avoid these common study mistakes. Keep your study plan simple with a few top-quality resources, then use them effectively and efficiently. For more information on UWorld’s Step 1 QBank, click here.

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