Why You Shouldn’t Neglect the Basic Sciences During Your Preclinical Studies

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Marcel Brus-Ramer, MD PhD

Most medical students recognize that the basic sciences–biochemistry, physics, chemistry, genetics, and cellular biology–are the foundation of medical science. Yet once these students are several months into medical school and its constant flood of anatomy, physiology, and pathology, they may be tempted to neglect the basic sciences to stay afloat. For many, spending even a little time reviewing science feels like unnecessary stress on an already tight schedule.

However, when they transition from rapid-fire preclinical learning to dedicated Step 1 study time, students are often alarmed to discover how many basic science fundamentals are included on the exam. That’s right: Step 1 routinely tests the intracellular location of important cellular functions, among many other cellular biology concepts! Sure, the USMLE may couch such concepts within a clinical vignette, but fundamentally, Step 1 tests the basic sciences. 

Thus, it’s often not until their dedicated study period (only weeks before the exam) that many students realize they should have kept the rust off their basic science knowledge. As the director of customized USMLE review courses for several medical schools, I frequently see students struggle with basic science concepts woven into clinically oriented questions. I repeatedly focus portions of our question-based seminars on integrating these basic science concepts.

The Best Way To Incorporate Basic Science Review Into Your Preclinical Years

The best way to relearn and integrate basic science concepts into USMLE study isn’t to return to basic science textbooks or class notes. Rather, the best method is taking lots of practice questions and encountering the concepts in a clinical context. Rarely is there a student who can simply recall at will all the relevant biochemistry and genetics facts. Most of us need to see the information placed in a proper clinical context for it to finally click.

At Elite Medical Prep, we encourage students to use the UWorld question bank early and often in medical school. There is almost no such thing as starting too early, and we absolutely discourage saving the questions until the dedicated Step 1 study period. Not only do UWorld questions improve your clinical knowledge, but the explanations also include thorough yet concise reviews of the most important basic science concepts, helping keep your knowledge fresh.

Doing a small batch of UWorld questions daily will keep your grasp of the material from fading and help you develop (or redevelop) the strong basic science foundation you’ll need to achieve a high score on Step 1.

The Basic Sciences Beyond Step 1

Even if Step 1 changes from a numerical score to pass-fail come January 2022, students will find that many concepts they learned during their Step 1 prep will still be applicable on Step 2 CK. For years, the two tests have had increasing overlap in their content. While Step 2 CK’s focus is clearly on clinical diagnosis and management, there are many questions on Step 2 CK that draw from Step 1 basic science knowledge. 

For example, Step 2 Ck will likely not test students on the individual components of the Krebs Cycle as Step 1 might. However, remembering that thiamine is a critical enzyme cofactor in the Krebs Cycle may help lead students to the right answer on a Step 2 CK question about the pathophysiology of thiamine deficiency (eg, Wernicke encephalopathy).  With the expected increase in Step 2 CK’s significance (once Step 1 transitions to pass/fail), it will be important for students to secure every advantage they can get!

I hope this quick overview of why basic science matters inspires you to keep reviewing these important subject areas. Study early, study often, and don’t be fooled if your medical school skims over basic science concepts. You will need them for Step 1 and beyond!

Give yourself the best chance to succeed in medical school and on your USMLE exam by preparing with UWorld’s comprehensive suite of medical exam prep solutions throughout your studies.

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