The United States Medical Licensing Exam (USMLE), which has been the bane in many medical students learning careers, has recently undergone some changes. From January 2022, students’ scores will be either “pass” or “fail.”

There’ll still be a numeric score for Step 1, but it will only be used to match students to residencies, so merely “passing” might not be adequate for many exam participants.

With ambitions of specialization and to get your first choice in residency, you’ll both need to pass the first time around and also get some pretty competitive results.

Reasons for failing the USMLE are pretty standard, however, and the mistakes that most students make are easily avoidable with the right preparation.

How to pass the USMLE Step 1

Use your time wisely

The purpose of the exam is to test a potential doctor’s ability to apply challenging and fundamental medical concepts to practice. The topics are vast and of immense depth. Furthermore, there won’t be much time to try and recall those key concepts from memory to answer those questions in an average time of one minute for each item.

Studying for the USMLE is difficult because of the sheer amount of information, which is why it’s crucial to use your time wisely.

Every student is different and will absorb information at different speeds, and through varying methods, so you don’t need to apply rigid techniques like the 10,000-hour rule or crash learning. But each hour you spend should benefit your performance.

You have to eliminate procrastination and passive studying, focus, and prioritize.

Apply ‘active’ learning techniques

Experts like a chess grandmaster and other people known for their excellence, don’t attain their titles from just putting in the hours. They learn by learning more smartly and applying purposeful learning over time.

To do the same, put aside notions of memorizing information on rote, this method only works so far, particularly over a short period of time. At some point, you have to start engaging with the material to absorb it and to understand how it applies in context.

As well as memorizing information, active learning techniques can help boost your ability to consume information and apply it later. For instance, write the material in your own words, or place it within diagrams and draw mind maps. You could also test yourself and prepare audio learning material as well.

Apply deliberate practice

Deliberate practice is usually applied by using information put together by an expert in their field, who has gone through their own struggle and journey to learn, implement, and prove themselves in the mastery of whatever subject is being taught.

It’s also structured information that can be repeated easily, and you should be able to get feedback as you go.

However, while deliberate practice has been touted as more effective than memorizing information, that doesn’t make it easy. It can be intense and lonely as it requires all your focus, which is why it’s only really done several hours in the day.

Focus on your weakest areas

It’s tempting to repeatedly focus on the areas of a subject you enjoy the most and are best at applying, but that won’t cut it when it comes to getting the results you want for one of the hardest exams going.

Preparing for the USMLE exams means confronting where you’re most vulnerable, and working on aspects of the material you find difficult.

Once you’ve learned this challenging material, by reading it, you’ll then improve your memory of it by hearing it, seeing the information, talking or writing about it, and even practically applying the knowledge.

How deliberate practice works

Now that we’ve established why deliberate practice is the best way of learning material, it’s time to consider how deliberate practice works.

Get your overview

If you’re thinking of studying for your USMLE exam, by now, you may already have attained the overview you need, through classes or practical lessons, either in the U.S. or abroad. This overview and substance should also be taken from experts like teachers and course provers.

Produce an outline

Outlining everything that you know or need to know can be a daunting task, particularly for medical students who have an enormous amount of information to cover.

Doing so, however, will help you start to structure what you need to know. Start writing topics and break them down further, then you will begin to see how they fit together.

Organize the detail

Once you have produced a linear framework, you can delve into the detail by organizing each topic in a more granular way.

Keep points concise and in an order that makes sense so you can easily repeat them.

Memorize the information

This stage is where memorization plays a role in learning. Go through each topic and repeat the process of memorizing each point. Repeating it to yourself and others will help you absorb this to an extent.

If you make mistakes along the way, pick yourself up on it or have others feedback, so you can rectify these mistakes and keep moving on.

Apply what you have learned

This stage is about delineating what you know and applying it to real scenarios.

This process could take the form of writing essays or answering practice questions. Repeat this process to perform better with each exercise and become faster with your responses.

Using different learning methods

As students, we all learn differently. Some people have an aptitude for learning in one way. In contrast, others benefit from all the different modes of information accumulation — reading, writing, diagrams, audiovisual, and practice.

Also, to note, different methods are suitable for specific stages of the process but not others.

Mind maps help provide outlines, but they don’t help with memorizing the detail. Audio might aide that process better, while your overview may be better served through both reading and visual methods.

How education is being taught is slowly developing as well. There’s a fundamental understanding that learning is a multifaceted process that requires an element of dynamism as well as adaptability. Furthermore, world-class solutions are becoming more available by shifting the mode of teaching online, making it geographically accessible and economical.

That’s why students are exchanging expensive courses to online solutions like Amboss, UWord and Lecturio to name a few. Lecturio for example; combines medical video lectures with interactive discussion with focus on spaced repetition; an evidence-based learning technique that is usually performed with flashcards and question banks to learn and apply and do so at a pace that works more organically and intuitively to a student’s natural capacity. This approach by Lecturio, and others, are trailblazing for the medical education industry.

This approach has been particularly transformative as COVID-19 has restricted physical classes, so online learning has become the new normal.

The one silver lining to that is that it may just have led to the discovery of more effective ways of revising and ensuring you pass that USMLE Step 1 with flying colors.

Cite this article as:
Editorial Staff, "Why Med Students “Fail” USMLE Step 1 Exam and how to pass it with flying colors," in Medicalopedia, July 23, 2020, [Permalink: https://www.medicalopedia.org/9102/why-med-students-fail-usmle-step-1-exam-and-how-to-pass-it-with-flying-colors/].