At Med School Tutors, we rely heavily on USMLE World in our work with students. Over the last five years, UWorld has become widely recognized as the gold standard Qbank for all steps of the USMLE. This is due primarily to the quality of its questions and rigor of its explanations. UWorld content is updated throughout the year, which keeps the Qbank incredibly current in the changing world of medicine and medical testing. Students who use UWorld achieve consistently top-flight results, but where do they go wrong? What are potential pitfalls that 2nd year students should make sure to avoid in their own prep? We've identified the 5 biggest mistakes that med students tend to make with UWorld (and in April 2015, we posted 5 more big mistakes).
1. Not starting USMLE World early enough
Many students come to us concerned about starting questions too early. They say they're not ready to tackle a Qbank as difficult as USMLE World. They would prefer to start with an easier Qbank or focus more on reading. This is a mistake! Step 1 is a question based exam. Therefore, the best approach to studying is to incorporate questions early and often. Even if you have not finished all of the material five months before your exam, there will certainly be some content you've covered. For example, if you've already had your immunology course, do some immuno questions! If you've learned biochemistry, create a few short biochemistry sets from UWorld! Attempting difficult questions is a great way to focus your studying and highlight areas of deficiency. Additionally, you might want to do questions on the topics you're learning in coursework. During your heme block 2nd year, do some heme questions. Remember that you can customize your question sets based on discipline. You can focus on heme pathology or heme pharmacology, if that is what your course is covering. No need to deal with biostats or biochem during a heme pathophys block. The earlier you expose yourself to difficult case vignettes, the more efficient your question-based studying will be later on.
2. Not spending enough time reading explanations in USMLE World
This may be one of the biggest and most damaging mistakes med students make when utilizing Qbanks. 240+ scorers know that the true value of UWorld lies in its high-quality explanations. The questions are prompts. They are vehicles for practicing the pattern recognition, clinical reasoning, and test-taking skills that we need to score high on the USMLE. However, doing the questions alone and skimming the explanations is NOT enough to achieve mastery of the material. Top scorers understand that UWorld is best used as a learning tool, and most of the learning happens when reviewing explanations—especially the incorrects. If there are 5 answer choices and only 1 correct answer, 80% of the content will focus on the incorrect answers. We must read all of the explanations—every word—to get the most out of the question. Does this take time? Absolutely! Students come to us and say, "I'm spending too much time on UWorld sets. It's taking me forever to review my blocks." We say, "No you're not. That's how we learn." Med School Tutors has found that students should spend 2-3X as long reviewing explanations as completing sets. This review includes looking up content in HY resources and making flashcards. Don't skimp on question review!
3. Not linking explanation review to First Aid
First Aid is the key book to use for Step 1 prep. We all know this. What many students do not know, however, is how to effectively integrate First Aid study with Qbank review. We think about the Qbank as a tool for illuminating or animating the content in First Aid. Anyone who has opened up First Aid to a random chapter and tried to read it through as a narrative knows how difficult this is to do. What we've found from our own study experiences and through our extensive work with students is that linking USMLE World to First Aid is an incredibly effective way to make the book content stick. This means that optimal Qbank review entails having a copy of First Aid ready to annotate—or even just to locate the information. Get ready to flip those pages! It's one of the best ways to learn First Aid.
4. Prioritizing percentage correct over learning content
Med students are data-driven individuals. We all love numbers, percentages, trends, etc. However, we fall intro a trap when we allow the numerical information provided by USMLE World to overwhelm the learning component. Students become overly enamored of percent correct and cumulative results, when what really matters is how much we are learning from the explanations. We cannot stress this point enough: UWorld is primarily a LEARNING tool, NOT an assessment tool. Additionally, students who focus too much on numbers are more likely to suffer study inertia. Why? Because these students are afraid to move on to the next question block until they've mastered the material. This leads to more reading, more watching of passive videos, more review of notes. Students move slowly to the Qbank to improve their chances of achieving high percentages on the next set. Let go of your concerns about numbers! Nobody will see your percentages. Keep the focus on where it should be: learning the exam content and improving test-taking skills.
5. Working through the Qbank once only
This is a big mistake that students make for many of the reasons described in this post: focusing too heavily on percentages, not wanting to waste the questions, wanting to start with an easier Qbank as a "warm up." What students often do not realize until too late is that there is an overwhelming amount of content in this Qbank, again, found primarily in the explanations. It takes multiple passes through the Qbank to embed the key points in our minds and derive the full benefit of this wonderful learning tool. Most students do not have photographic memories (we don't either), which means that repetition is the key to learning the material.
Mastery learning entails identifying the best resources and approaches, and working them repeatedly. If you are a 2nd year student and have not already done so, go ahead and acquire UWorld Qbank. Start working on questions right now. The earlier you start, the more likely you are to score high and join the 240+ club. We'll save a spot for you.