By: John Laurenzano
Throughout the first two years of your medical education, you will continuously be reminded of the importance of Step 1. Frequently regarded as one of the most significant factors in your residency application, the sheer mention of it can generate palpitations among even the most stoic of MS2s. By taking a well-thought out approach to this exam, however, you can set yourself up for success and knock it out of the park!
The reality is that your preparation for Step 1 significantly predates the block of time that you set aside to prepare. Whether your institution uses a systems-based or traditional curriculum, it is imperative to learn and understand the information in your pre-clinical classes. The best preparation for Step 1 is performing well in your preclinical curriculum. It’s always easier to remind yourself of old information than it is to learn new things.
While there are many different resources, there are only a handful that are truly essential– many others will be a waste of your time. Do your homework regarding what others have had success with and stick to one book per major discipline.
In general, 4-6 weeks is an ideal amount of time to solely prepare for Step 1. Longer than this and you risk burning out, shorter and you risk not being able to cover all of the necessary material. Before you start, lay out a standard day of studying, dividing time between reading review books and doing practice questions. Break up the time into different “blocks” for the different subjects. These schedules should not necessarily be strict but it’s important to keep them in mind so that you don’t run out of time. Spend more time on bigger subjects–nobody needs a week of embryology! Save a few days before the test to review high yield information and focus on practice questions.
I cannot stress the importance of test-taking skills enough. The adage “practice the way you play” has never held truer. Take a practice test before you start and 2-3 others throughout the course of your studying to keep track of your progress. One of the most common pitfalls in taking these exams is poor time management. While some can cruise through exams with plenty of time to spare, others find themselves hurrying against the clock to finish the last few questions. For this reason, always take practice exams under strict timed conditions and frequently time yourself performing practice questions.
Another common mistake with practice questions is telling yourself “well I would have gotten that right on the real thing.” You need to be honest with yourself as you study to identify where your weak areas are so that you can improve. Through continued practice under standardized conditions, you will be able to manage your time effectively and improve your score.
It is exceptionally difficult to stay completely motivated for 4-6 weeks of studying, especially when spending a lot of this time alone. It’s important that you make time for yourself. Take one day a week off to make sure you’re still doing things other than studying and medicine. It is very easy to get exhausted and frustrated. When you find yourself struggling to focus–take a break, find something else to do and return later. Sleep, exercise, and a healthy diet are very important and will help keep you on track. I can guarantee you the extra hour of sleep is more valuable than the extra hour of studying.
The night before the test, treat yourself to a nice dinner and skip the last-minute studying. It can only make you more stressed. Pack a lunch for yourself, some extra caffeine (if needed), earplugs, and some ibuprofen/Tylenol. Make sure to get a good night’s sleep and leave 15 extra minutes in the morning to get to the center (just in case). Most importantly, be confident that you’ve prepared to the best of your ability. After the test make sure to relax, celebrate, and pat yourself on the back—you’re done!