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A Day in the Life of Taking the USMLE Step 1

Your Step 1 test day can feel like one of the biggest days of your life.

Do well, and your dream of landing a competitive fellowship in a desirable locale will be cemented. Falter, and you may never get to live your dream of becoming a doctor.

Does this sound familiar? Eerily similar to the self-talk that’s been occupying your mindspace and interfering with studying?

Well, let’s take a minute to reframe things: If you’ve taken your Step 1 preparation seriously, and given this important milestone its due deference, then you will be able to absolutely use the opportunity to your advantage. But how exactly?

Preparing for any USMLE exam requires becoming a question-answering machine.

If you have been doing things right, you should have already realized that answering questions is paramount, and there is no substitute for it. You can internalize all 700 pages of First Aid, but if you can’t apply the facts and synthesize answers from the material, then you’ve got a head full of information but devoid of knowledge. Only by answering literally thousands of questions can you mold your brain into a device that is programmed to deliver correct answers.

Now don’t get me wrong. First Aid and the other primary resources have a definite place in your studying arsenal. But no matter how long your Step 1 preparation takes, whether it’s 4 weeks, 10 weeks, or 4 months, at the end of it, you will realize that your new, full-time-8-plus-hours-per-day job is that of a USMLE question answerer.

And that brings us to test day.

There is no arguing that Test Day is a big and important day. But remember, instead of stressing about the gravity of the situation, you should actively tell your mind to get excited for this day. In the end, it is just another day in the life of answering questions. Doing question blocks at home on a computer should feel nearly identical to doing question blocks at the test center on a computer. The software is even designed to look the same. You have gone through UWorld/Qbank blocks dozens and dozens of times before, and all of those times, you knew less than you do right now! Like an athlete preparing for competition, you have trained and trained (and then trained some more), put in dogged efforts, late nights, and tremendous focus in order to do well on Test Day.

By giving an unfaltering 100% effort throughout your preparations, you should be able to arrive to the test center, and confidently say to yourself, “I’ve done everything I can do to be poised for success. Now, I’ll answer questions, like I did earlier this week, like I did last month, like I’ve done every day. It’s just another set of question blocks, and doing question blocks is what I now do best.” Once you make this affirmation, and do so with total sincerity, you can devote all of your brain power to providing the right answer choices without any of the distractions or worries (e.g., Did I study enough cardio? Did I draw the urea cycle enough times?) that could possibly get in the way.

When I was an eager second-year student, I asked our upperclassmen who had crushed the boards, “How did you do it? What do I do to get my score as high as possible?” Everyone’s responses had one thing in common. It was not to memorize First Aid, or to watch every pathoma video twice. Nor was it to redraw every biochemistry pathway incessantly. The one thing that everyone had guided me to do was to focus predominantly on answering as many UWorld and Qbank questions as possible. I took their advice to heart, and when it was finally time to take the test, the knowledge, experience, and confidence were right where I needed them.

Use your Step 1 prep time to do the same, and by the time test day rolls around, you will not view it as an obstacle, but rather as an opportunity for you to succeed. Remember, it’s just one more day in the life.