Category Archives: USMLE

USMLE Step 1 Practice Questions – Why They Are So Important

The United States Medical Licensing Examination, or USMLE, is an essential test that determines whether a candidate is fit to begin practicing medicine in America. The first part of this exam, also known as the USMLE Step 1, determines whether a candidate is capable of applying the essential science and medical knowledge needed to the practice of medicine. In order to pass this part of the exam, it helps to first study some USMLE Step 1 practice questions.

The Array of Practice Questions

There are only a few different organizations that offer practice questions for the USMLE, but the high number of different questions is extremely helpful. When you access the practice questions, you will typically have up to 2,000 different options. Having literally thousands of different questions available means that you won’t get overwhelmed when you face the questions in real time. They also give you a feel for the type of questions you can expect to deal with. That means that you won’t have to worry about being caught off-guard by the format of the test. The USMLE does tend to overwhelm many new candidates, so getting used to the challenges ahead of time gives you an immediate leg up.

Preparing for Difficult Questions

Even if you spend some time preparing for the USMLE Step 1, the sheer complexity of the questions might throw you off when you try the exam in a live setting. Going through a large variety of different practice questions gives you a good feel for the level of difficulty you will be facing. While these practice arrays are not the same as the questions the actual exam has, they are of similar complexity and difficulty. This allows people who are taking the USMLE to react more calmly to the surprising level of challenge that the test presents. Just as you don’t want to go into a difficult medical procedures without being prepared, so too should you avoid going into the USMLE without proper readiness.

Familiarizing Participants with the Software

Almost any individuals such as those who are training to become doctors can get thrown for a loop due to unfamiliarity with certain software. The USMLE uses a specific brand of software to administer the test that many people have never seen before in their lives. Fortunately, those who take some practice questions ahead of time have a leg up compared to everybody else. The practice questions are administered using the same software that the real test uses. That means that if you have any moments where you find the visual layout or the software confusing, you will encounter that problem during practice. The more kinks you work out ahead of time, the smoother the test will go.

Taking the USMLE Step 1 is the first step on a path to a long and successful medical career. In order to make sure that you start down that path in the right way, trying some practice questions ahead of time is a huge benefit.

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Best USMLE Books

1. First Aid for the USMLE Step 1:

I don’t know how they do it, but the First Aid people have an unbelievable ability to know exactly what is important to the people who write board questions.  First Aid is reprinted each year. I suggest buying one copy early in med school and study from it while you study for your other classes. Then, purchase the new copy when you are studying for Step 1.  First Aid is not sufficient for Step 1, but it should be required reading for all students as it highlights the stuff that you absolutely must know. Some students also recommend Kaplan’s MedEssentials for the USMLE Step 1 Top Ten Books for the USMLE Step 1  Continue reading

The goal of this column is to provide you with the resources you need to excel in medical school. For more clinical resources, visit Emily Cooper’s blog, Med-Source, which she maintains as a “one-stop guide” for med students.

I was planning to expound upon pathology this month, but having just completed Step 1 of the boards (formally known as the US Medical Licensing Exam or USMLE), it seemed appropriate that I share the pearls that I gleaned while the material was still somewhat fresh in my mind. I studied for just over 5 weeks, which felt like just the right amount of time. Any shorter and I would not have been fully prepared, any longer and I would have started to forget what I learned at the beginning.

From the outset, I would highly recommend creating a study schedule in which you cover all of the material in First Aid during the first 3 1/2 to 4 weeks, doing at least 50 questions each night and then only reviewing questions during the last week.

The highest-yield online sites for the Boards are the question banks. Although pricey, the questions provide the best way to assess your progress and, next to First Aid, were my most valuable study resource.

  1.  Kaplan Qbank still serves as the industry standard. Your subscription provides access to more than 2000 questions that can be sorted by both discipline and organ system. A 1-month subscription costs $199, a 3-month subscription costs $279, and a 6-month subscription costs $499 (discounts may be available through your medical school). This program allows you to customize tests with your unused and/or incorrect questions, so that you can focus on your weaker areas. Although the interface is not identical to the real exam, it is close enough that the real exam will not feel foreign. Kaplan’s other strong points are their explanations for the answers. After completing a test, make sure to read the full answers, as a lot of information is packed into explaining why certain choices are incorrect.


  2.  USMLE World is the steadily growing upstart rival to Kaplan. They have now amassed more than 2000 questions as well, making this q-bank capable of standing on its own as a review source. The format is identical to the FRED format that you will see on the real thing. As with Kaplan, you can track your performance. I found the questions to be slightly more representative of the real exam than the Kaplan questions, but the explanations were not as thorough.


  3.  Practice exams provided by the National Board of Medical Examiners also come highly recommended and are available for $45 each. Other students who have used these exams say that they are the most representative of the real exam, with form 1 being the easiest and form 3 the most difficult.


  4.  When you register for Step 1, you get access to practice content. The 3 blocks of content are easier than the real exam, but they are a good confidence booster and are worth running through if only to know that you have covered the “official” material. The Kaplan Qbank subscription also comes with a .pdf file of explanations (an answer key without explanations comes with the content).


  5.  Also, be sure to check out resources offered by your school. At the University of Pennsylvania, we have access to USMLEasy, which provides online question banks for all of the step exams. If you don’t have free access, you can check out sample quizzes on Medscape and learn more about the Step 1 q-bank.

    The volume of print material available to prep for the boards is virtually limitless. Fortunately, First Aid — along with upperclassmen — should help you wade through and select the most valuable choices. Below, I listed the top 1 or 2 choices that my colleagues and I chose for each subject. It may be useful to go to your medical bookstore and look through the major series (High Yield, BRS, and Rapid Review) to decide which style works best for you. Also, First Aid has extensive reviews of the subject-based review books in the last section.

  1.  First Aid for the USMLE Step 1 2008 (Le T, Bhushan V, Rao DA): Treat this book as your Boards bible. Learn it, love it, know it. Take all of your notes in this book so that when you review at the end, you only have to go back to 1 book.


  2.  Biochemistry: Focus on the key enzymes and clinical consequences. Any one of the following will suffice:
    •  Lippincott’s Illustrated Reviews: Biochemistry (Champe PC, Harvey RA, Ferrier DR);


    •  BRS Biochemistry and Molecular Biology (Swanson TA, Kim SI, Glucksman MJ);


    •  High-Yield Biochemistry (Wilcox B).




  3.  Pharmacology: Focus only on those drugs mentioned in First Aid and master the general pharmacology chapter. I used only the flashcards and felt that they were more than adequate.
    •  Pharmacology Flashcards (Barron) — One side has a clinical vignette and the other has all the key information on the drug;


    •  Lippincott’s Illustrated Reviews: Pharmacology (Howland RD, Mycek MJ, Harvey RA, et al);


    •  Appleton & Lange Review of Pharmacology (Krzanowski JJ).




  4.  Microbiology: Clinical Microbiology Made Ridiculously Simple (Gladwin M, Trattler B)


  5.  Immunology: High-Yield Immunology (Johnson AG) or Medical Microbiology and Immunology (Immunology section only) (Levinson WE)


  6.  Pathology: BRS Pathology (Schneider AS, Szanto PA, Kim SI, et al)


  7.  Physiology: BRS Physiology (Costanzo LS)


  8.  Anatomy: High-Yield Gross Anatomy (Dudek RW, Louis TM)


  9.  Embryology: High-Yield Embryology (Dudek RW) or BRS Embryology (Dudek RW)


  10.  Neuroanatomy: High-Yield Neuroanatomy (Fix JD) or Clinical Neuroanatomy Made Ridiculously Simple (Goldberg S)


  11.  Behavioral Science: High-Yield Behavioral Science (Fadem B)


  12.  Histology: High-Yield Histology (Dudek RW)


 As indicated above, First Aid is the quintessential source for Boards review. Take all of your notes in this book, writing in it as you go over your q-bank answers.

  1.  During your review days at the end, go back and reread your annotated copy.



  2.  Do questions! Each night after studying, answer at least 50 questions on what you studied that day. Towards the end of your studying, complete blocks of 50 random questions to better simulate the real exam.


  3.  Know the basic pharmacology chapter. The concept of epinephrine reversal will be on your Boards.


  4.  Study with a friend. You may or may not want to actually study out loud, but at the very least you should have someone you meet everyday and sit with to help get you through. Five weeks is a long time to sit in a room by yourself.


  5.  Sleep, eat, exercise, go out. Your life doesn’t need to stop because you are studying. If you get going before 10 am, you should be done by 8 pm with time to chill out.


 One last thought: you will be fine. If you feel
overwhelmed, channel that energy into doing an extra block of questions rather than freaking out about the exam. Everyone panics a little at some point, but panicking is not productive. Doing questions is. Good luck!

Author of ‘USMLE Step 1 Made Ridiculously Simple’ Gives Tips

it also is the most important one for your future career. The score you will receive, together with the letters of recommendation from your 3rd and 4th year rotations will determine what kind of Residency you will end up in, and this will have major impact on your future. So please, take this exam very very seriously. If you are a US medical student, most of you will pass this exam, but it is incredibly important to achieve the best score you are capable of.

If you are on top of your class, most likely you will also be on top on the USMLE. If you are at the bottom of your class, most likely you will struggle with the USMLE, but there is nothing that could prevent you from also achieving a top score. So here are some tricks and tricks from my own experience with the USMLE:

The USMLE is quite unlike the exams you are used to. In med school, professors sometimes try to “trick” you into false answers. Not so on the USMLE. The USMLE questions are all professionally written, and there are no tricks. If a question appears too simple, don’t attempt to “second-guess” it, or search for a trap – there is none, it is simply an easy question. The USMLE is a mix of very basic questions, difficult questions, and some extremely difficult questions (designed to distinguish between the top 5% performers). So don’t get frustrated if you come across incredibly difficult items, just mark your best guess and move on. Everyone is in the same boat…

I went to medical school in Germany and then took the USMLE in the US more than 10 years later (when I had forgotten all my anatomy and biochemistry from long-ago 😉 There were two things that helped me achieve a top-score, and I am very passionate about these: First, find a study partner. The perfect size for a study group is exactly 2 people, cause it means you are constantly engaged. It is not important whether you are of similar skill and knowledge or not. You will be amazed how much you learn, when you are forced to explain topics to someone.

Second, practice multiple choice questions. Do as many as you possibly can. Around 100 per day sounds about right, but if you can’t do 100, then do 50 and if you can’t do 50, do 10. Put a book with questions right next to your bed, and do your 10 questions before you get up in the mornings, then contemplate your mistakes while you are brushing your teeth. Seriously. Start today!
There are many collections of multiple choice questions available. One of the best, but also expensive one, is Kaplan Qbank. I myself actually prefer book questions, cause I like to mark my text, underline things, cross out wrong things, flag all the questions I got wrong so I can easily review them later. Maybe I am old-fashioned – if you prefer to sit in front of computer screens, then use online Qbanks. Just make sure to WORK with the questions.

Don’t use them to assess your knowledge! Be happy if you get practice questions wrong, cause it means you learned something. Make yourself a list of all your mistakes, then review this list just the day before the exam. Believe me, my own list of mistakes was a couple dozen pages long (SMILE), but at least I knew that I wouldn’t make the same mistakes on exam day!
It is much better to study 2 hour every day for the next 60 days, then trying to study 12 hours a day in just the last week before the exam. Nobody will ever ask you about your Pathology or Pharmacology grades you got in med school (but make sure you pass…). Make the USMLE your top priority. Now!

There are many review books available for the USMLE. Much of it is a matter of taste and your own learning style. I myself (surprise, surprise) like my own “USMLE Made Ridiculously Simple” charts, cause I find them very efficient for memorization. If you need more explanations, use “First Aid for the USMLE Step 1”, this is the most popular of the comprehensive reviews and very good.
Good Luck!

Five Tips for Taking USMLE Step 1

Not looking forward to locking yourself away in a room to study for Step 1? Almost every med student has to undergo the grueling experience of studying for and passing Step 1. Is it simply a rite of passage? An unpleasant experience everyone must survive? Not necessarily. There are a few things you can do to help yourself thrive on Step 1 from the time you arrive at medical school…. Interested? Read on!
1. Identify weak areas as early as possible; that’s where you should start your review. This helps avoid procrastination. Be honest: who wants to study a topic that seems boring? Or an area you feel you aren’t great at (yet)? If you don’t start with your weak areas, it will be easy for them to stay at the bottom of your to-do list. By starting with these areas, you give yourself the necessary time to master topics where you have the most room to improve. Remember: topics where you have the most room to improve = areas where you have the most points to earn. Therefore, increased study in these areas = increased score overall!
2. Identify “time sinks” and change habits surrounding them. Do you get distracted by Facebook, email, texts, friend drama and the like? We all have time-wasting distractions, but you are your own boss during med school, and it is up to you to maximize your time. This is a direct investment in your future. Quickly identify your time sinks and reinvest that “lost” time into more-productive activities. This does not mean you should cut out balance activities! In fact, by reducing distractions and maximizing study efficiency, you should find yourself with more time to schedule things you enjoy. These balance activities can be incredibly motivating and are an important part of a good Step 1 study plan.
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3. Learn the material thoroughly in your courses. You want your Step 1 study time to be review. If you are not learning the material in depth first, your Step 1 studying will likely be much less efficient and much more frustrating. It’s kind of like reading the CliffsNotes of a Shakespeare play and expecting to know, understand and be able to apply the small amount you read to difficult questions. Shortcuts just don’t work if you want to thrive on Step 1. Success begins your first day in med school—if you fully apply yourself in the classroom and during your study time.
4. Your courses are your first priority. Do not allow Step 1 studying to overshadow your primary goal during the first and second years: passing your courses! The last thing you want to do is waste time studying for makeup exams. This will distract from your other coursework and, as the Step 1 study period approaches, take time away from your Step 1 studying.
5. Align your coursework with a first pass through the review materials. As you study for your courses, use some of the Step 1 review materials. Maybe even try a few questions along the way. BEWARE: Step 1 review books do not cover the material in as much depth as your courses, so you must use such books only to supplement your coursework. During the second half of your second year, as Step 1 approaches, you may want to increase the number of practice questions you attempt. Remember not to overdo it. You will have adedicated study period to focus exclusively on Step 1 studying. The structure of this dedicated study time will be important.
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How to decrease anxiety during USMLE Exam

Anxiety is a pretty “usual” feeling for the students who are very close to take their medical exam. Among the wide variety of stress symptoms we can mention some of these which can have an impact on you physically as well: dry mouth, feeling of sickness, palpitation or dizziness. Although students have gone through many types of exams during their year of studying, the thought of attending the medical licensing examination leaves a quite strong daily anxiety. This can have many times a negative impact on taking the USMLE, because the feeling of failing becomes permanent for many students, even before quite a long period before the day of examination.


Unfortunately many students’ feelings are dominated by the anxiety, and they do not even realize this. During their studies there is a wide range of medical exams that they need to take, so that stress and anxiety are ceaseless.  Not paying too much attention on this, it becomes unnoticeably constant, accompanying the students until the finish of the exam, or even further.

It is extremely important for the students not to stop preparing for the final examination, after they have successfully attended their exams. The medical licensing examination is very significant in a medical student’s life, because only after this “test” they can find out whether they can move ahead or in case of failing, they need to wait for the possibility of trying it again until they succeed.

Here are some useful recommendations for you to reduce the anxiety:

First of all, the most vital thing for you before your examination day is to take some real rest. You have to sleep enough in order to be in shape for the USMLE, your body and mind needs to feel relaxed and refreshed. Do not even think about spending a night hanging out with friends, right before your examination day, because there is no way that you can concentrate on what you have learned before. It is advisable for you to begin partying after you have taken your exam, as you can freely have a great time, without the fear of any upcoming exam.

The second thing which is important is that you should never go attending an exam without eating something before. Make sure that before you enter the examination room you don’t have an empty stomach, as for three hours there no chance for you to eat anything. You surely are aware of the fact that food plays a great role in the good functioning of the brain, so you should stick to that!


Always be positive when going to the exam, even if your colleagues are stressed out, because they feel like that due to the fact that they are not well prepared. There is a strong possibility that their anxiety has an impact on you, but only if you let this happen. Keep in mind that you are the one who can take control over anxiety.


Here are some tips on what you should do during the examination:

Pay a great attention to every single piece of information.

In case you come up with a question which you are not hundred percent sure of, don’t panic and resolve the other questions; afterwards you can return to it.

From time to time, you should change your sitting positions, this helps you to increase your chances of relaxing.

In case anxiety bothers you again, do not panic. Never ever start thinking about the outcomes of failing. You just concentrate on how to answer more effectively on the questions and try to resolve them as better as you can.


Another essential fact is that you should never take into consideration that a colleague of yours finishes faster the exam than you. This doesn’t mean that you also have to finish answering the question quickly.

The varieties of conditions are the ones which contribute to attending the USMLE in a successful or unsuccessful way; and once again, we enlighten that you are the only one who can overcome the anxiety and fear of the exam. If you succeed in controlling your level of anxiety step by step, you are guaranteed to benefit of great results in what the USMLE is consisting of.

3 Things Which Should Be Done Before Taking USMLE Step 1 and Step 2

The truth is that no matter how hard you study, you will always feel that there is something left and that you are just not ready to face the exams. More so if the exam happens to be the USMILE Step 1 or Step 2 exams! But don’t worry, as the following has 3 signs which will tell you that you are well prepared and good enough to sit for the tests! So here goes:

1. You have gone and completed at least one question bank and know everything in it quite well. If this is your study status, you are well prepared to face the dreaded exam. A lot of students spend their time doing the same question banks over and over again. While this may be partly fruitful, a better strategy would be to read the questions in the banks very carefully and take notes in the way of preparing the answers. This way, at the end of finishing a question bank, you will have a good notebook of notes to study from.

2. Trying the NBME tests is important to know how well prepared you are to sit for the USMILE exams. This is also a very important way to understand whether or not you are fit to get yourself into a tough specialty. If you see yourself scoring high you will know that you are well and good. But to be sure, take your NBME test again. If both the time you see that you have scored as high as you expected, then you are guaranteed to be ready to sit for your board exams. The NBME tests will give you an idea about the topics you can expect to encounter in your USMILE exam papers and will also endow you with a confidence of sitting in a real exam.

3. Have you got a good study guide book for yourself? Do you find yourself keeping it all the time and trying to know by heart all the high yield information it contains? A study guide book is something you just cannot ignore to invest in when you are preparing for the USMILE exams. Though the study guide should not the only thing you master, it is important. The information that a good study guide book will give you will make you stand out among your counterparts.

It is a good idea to spend some time with a pro before giving any type of exam.

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