Karolina Woroniecka, MD/PhD
For many years now, UWorld has unquestionably been the best question bank (QBank) for USMLE® Step 1 (and beyond!). While most students do not wonder if they should use UWorld, they do often ask when they should start using UWorld. This question has sparked considerable debate in the medical school community.
Some argue that beginning your USMLE studies during MS1 is too early and that students should focus on their medical school curriculum. Others argue that students should “start USMLE studies as early as possible to get the best score they possibly can.” I am very much on the “start early” team because it helped me succeed in my classes and Step 1.
Why I Started Using UWorld Early
My medical school gave us only one year to get through all the required preclinical content before starting MS2 clinical rotations. After MS2 rotations, we had a dedicated study period for both Step 1 and Step 2 CK, so we took Step 1 and Step 2 CK almost simultaneously.
Because of this compressed schedule, I chose to start using UWorld right away. I found that beginning UWorld early in MS1 helped me absorb and solidify all the important UWorld Step 1 content before studying clinical Step 2 CK content during MS2. I also found that it helped me refine my test-taking strategy early on. While not every school follows the same compressed schedule, each student must master a huge amount of preclinical material before moving onto clinical material and can benefit from starting the process early.
Common Concerns About Starting UWorld Early
Many students express concern about starting UWorld during MS1 because they think it will compromise their dedicated study time at the end of MS2. In other words, they worry they will remember too many of the questions.
Other students recognize the benefit of starting UWorld early. Still, they are quickly overwhelmed by the sheer number of questions in the QBank, most of which contain complex material they haven’t learned yet.
Both of these concerns can be addressed using a step-wise and targeted approach when starting UWorld during MS1.
The UWorld Approach I Recommend
When starting early, MS1 students should depend heavily on UWorld’s topic selection feature to customize their practice tests according to their medical school curriculum. At the beginning of each medical school module (eg, many schools start with biochemistry), students should check the corresponding Systems box (eg, Biochemistry (General Principles)) and ascertain how many questions are within that particular section.
The goal is to get through all those topic-specific questions at least once before the module’s medical school exam. Since some subjects have hundreds of questions, this may entail taking up to 20 questions per day during a standard month-long block. Therefore, I recommend that students find out how many questions there are at the beginning of each block to formulate an appropriate study plan.
Twice as Nice
If once through is good, twice through is even better. In my experience, many successful students get through all the topic-specific questions twice during their module—a first pass when they are learning the material and a second pass within a few days of their exam. The first pass is usually most effective when done using the untimed tutor mode; this encourages an unrushed and thorough dive into the material.
The second pass is typically done within a few days of the exam; this is a way for students to reinforce the content they’ve just learned throughout the topic block and practice exam-taking strategies and timing. Students should take the second pass in the timed mode with longer blocks of questions for more realistic testing conditions.
For many topics, students may be surprised to find that UWorld is more than enough to prepare them for their medical school exams, and they don’t need too many other resources. In particular, they often discover that encountering material through practice tests is a more effective learning approach than reading textbooks or watching videos.
The wonderful (though perhaps stressful!) thing about UWorld is that no textbook or other learning resource comprehensively covers all the content incorporated by the QBank. As a result, students learn extensively from the explanations while taking questions. That UWorld can be a primary learning resource is an important realization and can help those students who think they should save studying with UWorld for later.
Why the UWorld Approach
Another benefit of starting UWorld during the early months of MS1 is learning how best to use UWorld’s flashcard feature (or formulate other ways to retain critical UWorld content) while still accessing medical school material at a digestible rate. This skill, which takes time to perfect, is vital to studying effectively for both class exams and the Step 1 exam. Learning it early is better than learning it later when the time pressure and sheer volume of content become overwhelming.
Using this approach, students should be able to get through all of UWorld, ideally twice, before starting their dedicated study period for Step 1. Then students can reset their UWorld subscriptions and start afresh, taking timed blocks of 40 questions from all subjects and systems to prepare for the way that mixed questions appear on Step 1.
As medical schools seek to shorten the MS1 and MS2 years (even compressing MS1 and MS2 content into a single year in some cases), starting early with UWorld becomes increasingly essential. While this may seem daunting at first, it is actually much less intimidating to start early, and once students get into the swing of things, they might even have fun!
Give yourself the best chance to succeed in your USMLE exams by preparing with UWorld’s suite of USMLE learning tools during your MS1 and MS2 rotations.