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Over the course of any exam preparation--whether Step 1, Step 2, or Step 3--NBME scores begin to plateau. It is one of the most frustrating experiences as a medical student, and we all experience it.

Here are four useful tips to overcome the NBME score plateau:

1. Recognize how normal this is. A stagnating NBME score does not imply anything about how well or efficiently you are studying.

Don’t worry. Everyone experiences score plateaus on practice exams, and there are numerous reasons for this. There is no way for an exam to adequately test you on your specific growing body of knowledge, so there will be huge amounts of variability from exam to exam. You could be at a 250 level but get a 235 – that’s how much variability you could have by nature of being tested on a finite, specific body of knowledge. You could also have a bad testing day, or just have not been up to taking a practice NBME when you just want to get the real one over with. Often, we underperform on exam practices because they aren’t as important as the real test. Most students will interpret stagnation on NBMEs as a sign that they haven’t been studying the right information or that they are inefficiently studying – this is usually not the case. You’ve still been learning!

2. Change up your NBME study resources.

Even though you are probably studying just fine, sometimes you need a change of pace. Reading the same things over and over often means you are just remembering (and not remembering) the same pieces of information, no matter how much of it is high-yield and solid review for the exam. Find a new resource and try to commit to learning 1-2 new things each hour, and test yourself at the end of the hour. Write these things down on a flash card or notepad.

3. Space out your practice exams.

You might not be giving yourself enough time between practice tests. A week is a reasonable amount of time to expect a small improvement, but not a large one. With variability, you can expect your scores to stay the exact same (or even go down) if you take two practice tests within a week. To get around this, try to take your tests a bit farther apart if you can. If not, there is nothing wrong with taking your tests close to one another (just don’t expect to go from a 220 to a 260!).

4. Review your NBME practice exams.

Review your practice tests thoroughly and make sure you are not repeating the same mistakes over and over. The purpose of practice exams is two-fold: to gauge your progress, and to also learn a ton of high-yield, relevant, testable information. Even if you aren’t happy with your progress, you can still make progress by making sure you review the exam thoroughly by knowing why you missed some answers, and identifying your strengths and weaknesses. This way, even if your NBME score is not where you wanted it to be, at least you know you got a whopping load of knowledge out of it!

24 hours could earn you 30 more points