Medical School - Preclinical

How to Effectively use Note Cards to Study for Step 1

Tips to excel on Step 1

By: Abhinav Gupta

So, you’ve made it to the second year of medical school, and are now gearing up to take the first part of your board exams: Step 1! I’m sure you’re wondering how you’re going to remember all the information you have learned in the first two years of medical school, in addition to new material introduced to you while studying for this exam. I’ll let you in on a little secret… making notecards not only reduces studying time but also allows you retain information for months past test date. In this post, I will share with you how I used notecards to score a 258 on Step 1.

Make your own notecards

Use First Aid as a reference guide for identifying information you don’t know. When you come across a fact that you are having trouble remembering, reword it into a question on the front of a notecard, and then answer it on the back. Making your own notecards allows you to engage with the material more than highlighting a textbook or using pre-made decks such as Brosencephalon.

Use a computer program

Don’t try to write out all of your notecards on index cards. Not only will this quickly lead to some nasty carpal tunnel syndrome, but it will also be a nightmare trying to organize thousands of notecards. I recommend using Anki, a program that allows you to create, organize, and review notecards. It is mobile-friendly as well, so you can review your notecards at any time with your phone.

Organize notecards by system

It is easy to feel overwhelmed when looking at the total number of notecards that you need to review. The key is to create manageable chunks of cards. Try to make decks of cards based on organ system so that you can focus on topics you feel weak in. I followed the outline of First Aid to ensure that I had covered all sections in the book.

Use spaced-repetition to review your notecards

Spaced repetition is a way to triage notecards so you won’t forget information that you just learned. The idea is simple: the more unfamiliar you are with the material, the sooner you will revisit that notecard. This way, you also avoid reviewing topics you feel confident in. Anki uses spaced repetition to spread learning over time as opposed to cramming. The catch is, in order for it to be effective, you need to commit to completing both the new notecards and the previously reviewed notecards that are due for the day. Otherwise, not only will you quickly fall behind, but you will also bend the time-spaced repetition continuum by messing with the intervals between card visits. Don’t do that.

Miss a question, make a note card

Question banks such as UWorld are essential for Step 1 preparation. With thousands of questions in each Qbank, it’s easy to forget what you learned. Make sure to capture the lesson of each missed question by creating a notecard. Try to use the teaching point of the question (usually located at the bottom of the answer explanation) to make your notecard. Only use the information that was essential to answering the question correctly.

Set a target for each day

In order to cover all of information required for this exam, you should set a goal of going through a certain number of new cards a day (I did 20), in addition to the ones you have to review. Anki will create a daily learning plan for you, which will include notecards that you have just created and ones you have already seen. Know that the more new cards you are introduced to, the more you will have to review in the subsequent days.

Breakdown topics so you have one fact per notecard

Don’t fall into the trap of writing lengthy questions or answers on a single notecard; that’s counter-productive to learning. Breakdown the topic into single facts, so that you are not writing more than a sentence or two in either the question or the answer sections of the notecard.

Use notecards at multiple times of the day during your normal activities

One of my secrets for scoring well on Step 1 is to use your notecards whenever you can. I reviewed them on the treadmill, during meals, and even while waiting for my coffee at Starbucks. A few notecards at a time adds up, and utilizing breaks such as these frees up time for other resources.

Although everyone has their way of learning, one thing we can all agree upon is that Step 1 requires covering lots of material in a short amount time, and more importantly applying that information on test day. Making notecards and then reviewing them with spaced repetition was my key to remembering information that I had learned months before Step 1. Creating mini-questions and answering them also provided me multiple exposures to the material that ultimately cut down on studying time and gave me the score I was looking for.

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