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Virtually all medical students use the USMLE UWorld Qbank when preparing for their Step 1 exams. This Qbank is well-known to be one of the best resources for preparing for Step 1 by helping students actively learn high-yield, relevant material. While it is universally accepted that using UWorld is a must, how many times a student should complete the Qbank is more debatable. In this article, we will discuss the Do’s and Do Not’s of using UWorld multiple times.

DO complete one full, thorough pass of UWorld.

It is absolutely necessary that all students studying for Step 1 complete UWorld at least one time. This is because the UWorld Qbank is a wealth of high-yield, relevant material written in a style which mirrors the Step 1 exam, so completion of the Qbank correlates with step 1 success. I always remind students the UWorld is a learning tool, not an assessment tool, and so the goal is to use the Qbank as a means of studying to learn the material. Students should not stress about their scores or percentiles nor should they delay using the Qbank until they study other material in an effort to bolster their UWorld scores. It is often appropriate to take subject based tests for this first pass of UWorld. Some students use UWorld while taking school-issued NBME subject exams. In most instances, I encourage students to make and use a UWorld journal during this first pass of UWorld, as previously described HERE. If a student is not on track to finish a complete first pass of UWorld before their Step 1 exam, this is often enough justification to consider pushing his or her test date.

DO consider how much time you have before your exam to determine the type of second pass.

Students have multiple options when deciding if or when to complete a second pass of the Qbank. As long as a student has completed a full first pass, the length of time until test day typically dictates this second pass. For students with a significant amount of time, they may consider re-setting the Qbank and completing it again in its entirety. This is often appropriate for students who used UWorld throughout their coursework and want to reset it at the start of their dedicated study period. More often, students have 1 to 3 weeks between finishing a first pass of the Qbank and sitting for their Step 1 exam. In this instance, I generally encourage students to re-do all of their incorrect questions and, if time permits, re-do questions which they had previously marked and/or they feel are weaker subjects. It is often appropriate to complete mixed subject blocks of questions on this second pass.

DO NOT continue multiple passes of UWorld if you have memorized all the questions/answers.

In some circumstances, it may not be beneficial to complete UWorld multiple times. This is particularly true if a student has memorized the questions/answers in UWorld without fully understanding or learning the material. In these cases, students may get many questions right in the Qbank but cannot explain why and often struggle to pass NBME practice tests. For a student that is attempting a second pass of UWorld and finds this is the case, using an alternative Qbank such as Kaplan or USMLErx may be appropriate to provide a new array of questions. It is rarely necessary to complete third or fourth passes of UWorld, as most students’ doing so find little added benefit.

In summary, the key to a high score on the USMLE Step 1 in part comes down to using UWorld efficiently and effectively. All students MUST complete one full pass of the Qbank, and most students should complete partial if not full second passes. For students who feel they have memorized the questions and answered without really learning all the material, switching to a second Qbank may be necessary. Few, if any, students will want or need to complete UWorld more than two times.

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Lauryn Falcone, MD, PhD

Lauryn Falcone, MD, PhD

Lauryn Falcone graduated Summa Cum Laude and as co-valedictorian from Rollins College before pursuing an MD/PhD degree at West Virginia University School of Medicine. She is currently a Dermatology resident at UPMC in Pittsburgh, PA. She pursued a PhD in cellular and integrative physiology at the National Institute of Occupational Safety and Health (NIOSH) in a respiratory toxicology laboratory. Lauryn completed her first two years of medical school as an honors student, scoring a 254 on the USMLE Step 1 examination and achieving above the 90th percentile on eight NBME shelf exams. Lauryn has a strong passion for tutoring and mentoring students and enjoys helping them navigate the challenges of medical school.
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