Words of Wisdom

Northwestern University Feinberg School of Medicine students who scored more than one standard deviation above the national mean on the United States Medical Licensing Examination Step 1 offer words of wisdom related to the exam:

Consider saving unseen UWorld questions for the last week to keep yourself fresh. I know a lot of people who restarted UWorld and didn't think the second time through was very beneficial. I would suggest to only redo questions you have flagged or incorrect rather than restarting the entire bank.
For all the nappers out there, I found taking naps in the afternoon a successful way to kind of restart my drive to study afterward. Its usually hard for me to wake up from a nap and be productive, but I always felt a little bit guilty when I would take a nap and that consciously reinforced high productivity when I got back to it afterward.
Find something you actually enjoy doing for study breaks. For a lot of people that's working out, which is really healthy and great. For me it was watching Netflix while meal-prepping. This definitely helped me get through the day.
Know that it's okay if you don't reach all the goals you set out to in the beginning. Adapt throughout and move on.
Protect your time starting in pre-dedicated studying after winter break. Be free of responsibilities besides Feinberg exams and Step studying by February if at all possible. Do not multitask during the dedicated study period. If people around you are stressing you out before dedicated, avoid those people or avoid talking about Step. There is no reason to indulge in this toxic environment. Strongly consider going home for dedicated. My mom cooked for me, did my laundry, and I wasted no time leaving the house to study. Exercise every day. Stick to your routine. Eat well. Don't drink (I had one drink a week, maybe). Feel free to spend about 30 to 45 each day watching a TV show or doing some other relaxing activity. Take at least one full afternoon off each week to do something fun. Plan things to look forward to (dinner, activities, etc.). Don’t be discouraged if your score doesn’t change significantly after about three weeks of dedicated. My score went up only 15 points between my first and third practice Step and I was worried. I went up 10 points alone between my third practice test and my real Step 1, so the vast majority of my progress occurred over the final two weeks. Obviously, you should be doing practice tests about once a week (mine were every nine to 10 days. Don’t be afraid to go back to the basics/fundamentals if you don’t understand something (examples: lung/cardiac physiology, brain anatomy, etc.). You need to rebuild your foundation before you can build on top of it; it is worth the time investment. Take a vacation afterward. You deserve it. Stay in touch with friends.
You can get a good score even without always being at the top of the class (or even if you've failed an exam) preclinical or grinding out UWorld for six months prior. It's important to try hard preclinical, but dedicated time is a blank slate so use it to your advantage and enter it confidently despite what expectations you may have already set based on other people.
If you're super anxious about your score and feel like you're not improving on UWorld, you're not the only one. If you take an NBME practice test and do much worse than you expected, you're not alone. So many of us had moments where we hit the wall and seriously doubted our ability to make it through to the end. But we did. And so will you.
Second year is hard. People are really stressed, constantly talking about Step, and everyone's doing different things to study and you can fall into the trap of trying to play catch-up all the time, or you can also fall into the trap of just avoiding doing any studying until dedicated. It's hard to find a happy in between but I think for most people it's important to at least do some studying before the four to five weeks you take to study for the exam. However, don't get frustrated if you feel like you're not making progress during the year. The time during dedicated is so much longer than you think. Scores that stall during the year start shooting up during dedicated, what takes you a week to get through during the year takes a day during dedicated. Even if you sleep eight hours a day, you have 16 hours left during those weeks ... and nobody can study 16 hours a day. That leaves plenty of hours to eat good food, see a friend, watch lots of TV. Honestly, dedicated felt a lot saner than the year does because you're not trying to do 10 other things at the same time. It was great for me to study at Galter with a few of my friends in sight, but not studying with them. It allowed us to take quick sanity conversation breaks without getting stressed about what each other was studying.
Work hard the first two years (and supplement with First Aid and Pathoma). I strongly believe that if you perform well on Feinberg tests, you will perform well on Step. Take breaks: not sort-of breaks, but real breaks. Take evenings off and even weekends if you're feeling too pent up or stressed. See your friends (especially those not in med school because they truthfully couldn't care less that you're taking boards, and that is a great thing).
My biggest words of wisdom are that everybody prepares differently and that you should come up with a schedule based on how you learn and stick to that without worrying about how other people are studying. Easier said than done, but I think it's a really important thing to remember. I started studying much earlier than most people, doing some boards studying almost every day of M2, but then didn't have to work as hard and cram during dedicated time. This suited me but is not at all what I would recommend for everybody. You know yourself better than anybody, and you know how is best to study for you. Also, pick only a few resources and stick with those. Just because your friend is using this or that, does not mean that you need to use every resource that other students are using. My recommendation would be to use First Aid, UWorld and one more. But again, everybody is different and if you feel like you need a little bit of extra than that for one (or more) of the organ systems, then go for it.
When I sat down to take the test, right before clicking start I had this rush of anxiety. The last few months I had spent trying to predict which questions I would see, and I was about to find it and it was nerve-racking. So on the day of your test, remember to not change any of your strategies. The test is exactly like the stuff you've prepared for, so don't change anything.
Set a test date and don't change it. If you give yourself the luxury of having the option to change your test date, you might slack off and not study as hard as you could. Commit to a date, work hard, work efficiently and believe you will perform when the time comes.
Do not be afraid of taking less time to study than others. If you like studying at a heavier pace, do not feel pressured to schedule your Step 1 date as late as your friends/classmates do. After hearing of my classmate’s test dates, I nearly pushed my own back as I was nervous about how early I was taking it; fortunately, I kept it when it was. If I had pushed it back at all, I would have without a doubt hit diminishing returns on my studying and missed out on a fun trip with my friends.
Take days off. It is a really long haul, and you need to take care of yourself. I did only half days of studying on the weekends and then would do something fun, work out, hang out with my boyfriend, etc., for the rest of those days. It can be hard to take time off, because there's always something else to do, but you will burn out. Also, it's impossible, but try not to let NBMEs discourage you. I know that it's not always true, but those scores were not indicative for me, and I wish that someone had told me that it's important to consider not just what you get on an NBME, but also how you're doing on UWorld and take the whole picture into account and try not to let it get you too down (easier said than done though).
Be flexible with your schedule. It's easy to get stressed if you get behind schedule and to not let yourself do non-studying activities because you're so caught up in staying exactly on schedule. You don't need to. By the last weeks, you'll have things that are getting repetitive and you can drop and then catch up in other areas.
Be selfish during dedicated time. That sounds like weird advice, but it's advice that my mom gave me during the first week and it was so important. I had a trip planned to visit friends during the middle of dedicated time as well as a family weekend, and I felt too guilty to cancel them but also stressed about doing all that while also studying enough. Just remember that your friends and family will understand and want to support you, and it's okay to be a bad friend for a month. Your sanity and studying comes first. Just be open about it, and everyone will understand. On the flipside, friends and family can be a huge resource during this time. It's nice to either see or talk on the phone with people who aren't in Step mode and be reminded that there's a whole world outside of First Aid.
Don't overload on resources (UWorld, First Aid, Pathoma and Sketchy are a lot as it is). Trust your preparation going into the test, and be confident.
My best advice would be to relax, which is easier said than done. The test is hard. There are things you won't know. There are things that you do know but will forget after five hours and 200 questions. Just realize this early and don't let it scare you. For me this was comforting, took some of the pressure off and made the whole process of studying and taking the test more bearable, and I think that the lower stress level helped me in the end. NBME will always find something to ask that you just haven't heard of, so just realize that you can't get them all and that no one will. Similarly, try to think about things in a way that will help you third year. Organize differentials, try to understand mechanisms and build some system to understand conditions and treatments that isn't based on buzzwords. If you hit something you've never seen, as often happens, this understanding will hopefully serve you well, as well as help you out next year.
The most important thing to take care of during dedicated time is managing your anxiety. Having a routine helps greatly with this. I would usually get up around 7 or 8 a.m., have a leisurely breakfast/listen to a podcast, and then walk to the law library. I would start my day with two to four UWorld blocks because I was always the most focused in the morning. I would try to be done reviewing the blocks my early afternoon. At that point, I would take a lunch break and go for a run. After, I would spend a few hours watching Boards & Beyond, Sketchy, Pathoma, etc. I would never study past 7 or 8 p.m. It’s important to relax before going to bed otherwise it will be hard to sleep. It is also totally okay to take a full or half day off once a week. You will never feel like you know every detail about everything, or even most details, but at a certain point you will take the test and you will do well if you pick a plan and stick to it.
I would not change much from what I did. I started seriously studying early (Thanksgiving Break) and got through one pass of First Aid, Pathoma and UWorld before dedicated period began. This allowed me to relax and pick out the material I was weakest in during dedicated.
Plan out a realistic schedule ahead of time and stick to it, start studying seriously and early and use a limited number of resources. Many people feel the need to try out several different resources. I suggest sticking to the few resources (three to four) that are most highly rated and master those as opposed to adequately studying too many resources. Use the NBME exams as a gauge for how you are progressing and to see what actual USMLE Step 1 questions are like.
While you should listen to people's advice, you know yourself best and the way you are most productive studying. Don't be stressed by how other people are studying or what other people tell you to be doing to study. Be confident and do what works best for you.
You will be okay. There will be a couple months of stress and boredom and you will think everyone else is doing more/better studying than you, but it's not true. Just do your best with First Aid and UWorld and remember you will inevitably one day be a doctor.
You do not need to be miserable during M2 year or the boards studying period. Don't buy into the neurosis. Work hard but don't stress.
Get plenty of sleep and exercise (both augment memory, improve mood and reduce stress) and at least once a week get some exposure to the outside world. Spend time with friends outside of medicine or spend an evening once a week watching a movie. The point is not to obsess about the boards constantly. I have some peers who did well on the exam who disagreed with me on this last point, but I really believe that it was important in helping me succeed.
Remember that the boards is an endurance test. Don't let the seven to eight hours of testing wear you out. Do all those smart test-taking things (eat snacks, use your break time, etc). Give each question a fair shot, but if you don't know it, pick an answer and move on (and pray that it was a pilot question anyway). Remember that there are easy questions at the end of the block that you don't want to run out of time on. And when you're finished, celebrate.
Definitely use this time as a way to bridge your knowledge from the books to the wards. I'm surprised at how much information I've retained as an M3 just from my boards studying. While some of the sections will surely be annoying (yes, reviewing 90 percent of the biochem chapter will make you want to just hit your head repeatedly against a brick wall), just know that you seriously will use this information in the future, so it's not all for nothing.
Keep in mind that your M3-M4 year grades are likely to be even more important than your individual board score, and that many factors are considered when applying to residency. Don't stress out, because in the end this is really just one of many pieces of a puzzle.
Trust your abilities. You know what works best for you, so do not get overly concerned with how someone else is studying
Med school really is the best preparation for this exam, and Feinberg prepares you better than most places. Get organized. There's too much stuff to cover, and unless you make a plan, you'll miss something. But once you're organized, stick to it don't waste time re-hashing organizational strategies when you should be working on material. Block out time to exercise, eat well and sleep. It's good advice for your future patients and its good advice for you. Group study keeps you accountable — no one wants to look like an idiot in front of or let down their friends. Take a day off per week. Or if you can't stand it, do a block or two of questions and then call it a day. You had a life before boards and you'll have one after; keep some perspective.
Don't stress out/panic, especially as the exam nears. The best way to do that is to familiarize yourself with the questions as well as the format of the test day in every way possible. I highly recommend going to the test site and doing the practice exam. Even though the practice questions there may not be entirely useful, knowing where everything is and how everything works is essential to decreasing the stress level. Also start early — even at the beginning of the M2 year, I would go to the library and check out some review books just to understand the topics that will be covered and the format of the test. Starting early also decreases stress later on.
I never believed people when they told me that Step 1 was going to be just fine but I'll share the same advice I was given. Study hard during your second year and you will do well on Step 1. Sure, a lot of what we learn second year is not going to be on Step 1, but it will give you a framework to learn what is required for the boards. Second, it is true: You do not need to worry or think about Step 1 for quite a while during second year, so don't let your nerves get to you. Lastly, try to do things you enjoy while you are studying for Step 1. You have to study hard but that doesn't mean you can't enjoy your month studying.
The best advice I can give is to stick to First Aid and Qbank. They are exponentially higher yield than all other resources and, unless you can recite everything in them from memory, you probably should not divert your attention to other resources. Try to work as much as you can during the day without diverting attention to email, internet, etc., so that when you get tired at night, you can stop without guilt. Also, during the year, practice studying directly from the resources you are provided rather than spending time reworking information into your own study guide. This will allow you to be more efficient when studying for Step 1 when you are pressed for time. And lastly, don't kill yourself during the school year. You will be busy enough and anything you study early in the year will be forgotten by the time the summer arrives.
I don't think there is one right way to prepare for this — just don't get too bogged down during the year trying to prepare for Step 1. You could use your off time during winter breaks and thanksgiving and spring break to review stuff. If you've already done a good job going through some M1 stuff as you go through M2 and keeping good notes, you won't have any trouble quickly reviewing it from first aid. Try to take a day or two early on during one of the breaks and get Biochem/Genetics out of the way. If you've gone through it once, it makes it very easy to review and you'll get tons of questions on just these two on Step 1.
Do not panic. Do not compare yourself to your classmates. Do not panic. You have more than enough time and more than enough smarts. I threw up from nerves (about something else!) on the morning of my exam and I still did well. Do not panic. Don't skimp on the curriculum to get a head start on studying and don't listen to the people who are doing that. Leave your apartment at least once a day. The world is still out there. You're going to be fine.
I don't care if I'm the 1,000th person to say this, but it's important so I'll say it again. Sleep, eat well and exercise. Honestly, I think that was the most important thing I did. I absolutely focused better and learned better on days when I was doing all those things. Take at least one full day off a week (whether that's one full day, two mornings, two afternoons, whatever). Schedule it so you don't feel guilty, and actually do it. I swear it helps and that extra three hours is not going to affect your score one way or the other. Final reminder: This is just an exam. Really. It's one exam — an important one, but still just one single exam. We've all taken exams before. Try not to work it up to be something that it's not; it won't help your score.