“If you want to do well on USMLE Step 1, do two passes through UWorld.”
Any medical student can tell you that this advice is as ubiquitous as it is overwhelming. With thousands of questions to grind through before test day, many students have a hard time imagining how they’ll make it through a single pass of the UWorld question bank (QBank), much less two complete passes. How, then, do so many students manage to do it?
It all comes down to planning, planning, planning. In this post, we’re going to layout a template for how you can plan, complete two full passes through the UWorld QBank, and earn yourself the score you want on Step 1!
The First Pass
The most manageable way to complete two passes through UWorld is by splitting them into two different phases. The first of those phases (your first pass) takes place alongside your first- and second-year medical school curriculum (well before you ever start your dedicated study period!).
To begin, you’ll want to activate a UWorld subscription. Then, as you encounter each new topic in class, check the UWorld QBank to see how many questions are available for that subject and/or system, and then complete the following calculation:
# topic questions / # days in the topic block = # of questions to do each day
For example, many medical schools begin with a roughly three-week-long tour of biochemistry. If that is your first topic, check for the number of UWorld biochemistry questions and then divide it by 21 days. For most topics, the above calculation yields about 8-12 UWorld questions per day to make a complete pass through the QBank before your dedicated study time. (Of course, medical school can be busy, so work ahead on days when you have time so that you’re prepared for the days when you don’t!)
During this first pass, don’t worry about timing your question blocks. Don’t even worry about whether you’re getting the questions right. Just take it slow, do the questions in tutor mode (so you see the explanations immediately after answering the questions), and take advantage of UWorld as a pure learning tool. Trust me—the time for self-assessment will come soon enough.
The Second Pass
Now it’s time. You’ve passed your pre-clinical classes, you’ve completed a full pass through the UWorld QBank, and your dedicated period of study for USMLE Step 1 has arrived. What do you do?
First, reset your UWorld subscription. This will erase all the statistics you accumulated during the first two years of medical school and allow you to more accurately track your progress during your dedicated Step 1 study period.
Next, calculate how many UWorld questions you’ll need to do each day to complete a second pass during your dedicated study period (making sure not to include any “off days” in this calculation):
# questions per day = total # of UWorld questions / # days in your dedicated study period
The calculated number of daily questions (often between 60 to 120 questions) depends on the length of your dedicated study period (usually between 4 and 8 weeks). So knowing how many questions you think you can realistically do every day can help you schedule your test day (so that you don’t have to push it back at the last minute). It can also help you determine exactly when to start your second pass.
Once you have started your second pass, make every effort to stick to your calculated number of questions every day. There are several benefits to this:
it will provide some much-needed structure during a long and challenging period of intense, self-directed study; (2) it will give you a reliable indicator of whether or not you are falling behind; and (3) it will help transform large UWorld question blocks from a burden into a habit (one that will help you on test day, when you encounter seven of these large blocks back-to-back!).
How long should I spend on UWorld questions during my second pass?
Because this is your second pass through the UWorld QBank, you should set your blocks to “timed” and “random” so that you’re practicing under testing conditions. You’ll also want to start doing full 40-question blocks to increase your efficiency and enhance your test-taking stamina.
On timed mode, UWorld allows 90 seconds per question (the same amount of time allowed on the Step 1 exam). Thus, a standard 40-question block will take students no longer than one hour. Since most students will be doing 1-3 blocks of 40 questions during their dedicated study period, they should expect to spend 1-3 hours a day answering questions.
However, answering the questions isn’t everything; once you’ve gone through a block, you’ll need to go back through and review the explanations for the questions you just did. This is where most students tend to fall behind.
That’s because most students make the mistake of reviewing all their UWorld explanations equally. With 40 questions in a block, even 90 seconds of review per explanation (which is hardly enough for most UWorld explanations!) will add up to an hour of study per block. At such a pace, most students would end up dedicating a minimum of between 3-6 hours (1-3 hours for questions plus 1-3 hours for explanations) a day to UWorld! As you can see, a more nuanced approach is necessary.
Students who struggle to review their daily UWorld questions on time are often tempted to cut down on the number of questions they do every day. Don’t make this mistake! Your daily question quota is based on the calculation you made based on your study schedule; adjusting it will seriously jeopardize your ability to make it through your second pass by your test date!
Instead, it would help if you triaged your explanation review. This way, you’ll stay on track by answering the same number of questions every day and make up time by simply reviewing them more efficiently.
So how do you triage?
First, for any questions that you answered correctly and feel confident about, limit yourself to skimming the explanation. Suppose you already have enough expertise to answer these questions correctly. In that case, your main goals are to reinforce your knowledge and keep an eye out for any extra details that might pop up in the main explanation or the explanations of the wrong answer choices.
Next, triage your review of incorrect answers using the following calculation:
(100 – (your average score on UWorld question blocks)) = cutoff for review
Using this calculation, if you typically answer 60% of UWorld questions correctly, you should focus your review on questions you missed, but 40% (ie, 100 – 60) or more students got correct. As your score rises toward 70%, your cutoff will naturally adjust itself downward toward 30%. Once you improve up to 80%, your cutoff will nosedive toward 20%.
Obviously, the smaller the percentage of students answering a question correctly, the harder the material is. By triaging your review to those questions within your calculated range, you avoid spending precious time on the most difficult material and focus your review on what is most within your reach!
What if I don’t have time for two full passes?
Some students may not be able to accommodate two full passes through the UWorld QBank. In that case, the best strategy is to use the above planning methods to complete one full pass and then do a second pass through only the questions you answered incorrectly the first time. Yes, you will miss out on some material you’d probably benefit from reviewing, but at least you’ll be focusing on improving your weakest areas.
In Summary: Start Early, Study Often
In many ways, medical school is all about planning and time management, and it’s never too early to start preparing for what’s ahead of you. By working with the UWorld Step 1 QBank early and often, you can enhance your preclinical coursework and work toward Step 1 mastery all at the same time!
Give yourself the best chance to succeed on the USMLE exams when you prepare with UWorld’s USMLE learning tools.