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How Many UWorld Questions Should You Do in a Day?

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by Alec Palmerton, MD in Plan
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Are you wondering how many UWorld questions you should be doing per day? Have you been told by your friends/school that you should do 100+ questions per day? Are you curious to know how many UWorld or other QBank questions you can do EFFECTIVELY in a day? If so, this article is for you. We will discuss:
  • How many UWorld questions you should be doing per day,
  • The most important metric you should be following (hint: it’s NOT the number of questions per day),
  • Why the evidence/rationale for doing lots of questions is flawed for many people, and
  • Much more

Summary:

  • High USMLE scorers typically have done many UWorld questions
  • However, correlation ≠ causation; people with stronger backgrounds will do/review questions much faster
  • The ideal # of UWorld questions to do every day should be determined by how much you can master, NOT an arbitrary number

Table of Contents

UWorld Questions: More Is Better…Right??

We’ve all heard the advice, most commonly from schools/Reddit: Just do lots of UWorld questions The evidence is simple: the students who score high tend to be the same students who do many UWorld questions. Ergo, to score high, you should do lots of UWorld questions. Voila! Done!
Correlation ≠ Causation
As we’ve discussed before, correlation does not equal causation. In other words, it is very plausible that doing lots of questions does not CAUSE scores to go up. Instead, students who have mastered the most material will score higher AND do more questions. What if I told you that the best NBA players generally took the most shots per game. Then, what if I told you all you needed to do to be the best NBA player was shoot every time you had a chance? The more shots you took, the better the player you’d be! The logic is flawed – the best NBA players take the most shots per game BECAUSE they are the best players. Therefore, teams will want the players to take the most shots; the attempts are a marker of their skill, NOT their cause. In the same way, students who already know a lot will be able to move through questions more quickly. Again, their mastery of the material – not the number of questions they’re doing per day – is why their scores are so high.
Why the Fixation on the Number of UWorld Questions?
Why do we care so much about how many UWorld questions we do? Because it’s easy to measure. However, remember that what’s measurable isn’t always important, and what is important is always measurable. But if the number of QBank questions/day isn’t the best predictor of USMLE scores, then what is?

Mastery Is the Best Predictor of Final Step 1 and Step 2 CK Score

Common sense, experience, and the NBME’s own goals demonstrate that mastery is the most important predictor of success. Why? Because the USMLEs test the application of concepts – not the regurgitation of information. If you get a question wrong – and speed through your “review” of it – you are no closer to getting a related question correct the next time. Yes, if you memorize the details of that question, you will have a reasonable shot at getting the same question right again. However, if you don’t take the time to master the material – learn how to integrate and apply the related concepts – you’ll be stuck when the details change.
The USMLEs Test Concepts but Vary the Details
And the details will change! There are virtually infinite ways to test a particular concept. Imagine that you missed a question on cardiogenic shock. You might memorize that the detail you needed to know was that the cardiac output is low in cardiogenic shock. Simple, right? However, do you think they will always ask the question in the same way? Of course not. The next time you see a question on cardiogenic shock, it may ask you what the left ventricular end-diastolic volume is. Or perhaps the hydrostatic pressure in the pulmonary capillaries, left atrium and right ventricle. Or maybe the serum lactate levels, urine output, and temperature of the extremities. If you don’t UNDERSTAND the concepts, you’ll be confused when they change the details but keep the ideas the same.

So, How Many UWorld Questions Should You Be Doing Every Day?

The short answer to how many UWorld questions you should be doing every day is this: Whatever you learn, learn well. Do as many UWorld questions as you can to ensure that you understand the vignettes/concepts tested. I have two notes of caution with this advice, however. First, don’t get sucked into the opposite problem of developing PhD-level knowledge for every question. There is a balance between breadth and depth. Most people are rushers (you know who you are). However, a minority of people out there have the opposite problem. They tend to be former engineers, physics/math/chemistry majors, or PhD-types. These people often need to learn how to strike a balance between depth and breadth. Second, don’t use mastery as an excuse to avoid doing QBank questions. So often, people feel anxious about doing QBank questions – mainly if their scores are stagnant and they feel overwhelmed. “Mastery” (often in the form of watching many videos) can be a convenient excuse for avoiding the discomfort of doing questions. Be honest about what/why you’re studying in a particular way. Most importantly, use QBanks to identify what you’re weak at – and master the related concepts you find.
So, How Many UWorld Questions Is Reasonable to Do Per Day?
You probably started this wondering, “what is the best number of UWorld questions I should be doing in a day?” However, the answer isn’t as simple as that. Depending on your stage, there is a range of questions you might find a reason to do. For example, if you’re feeling very overwhelmed and like you know little to nothing, it is reasonable to start with ~20 UWorld questions/day. However, if you’re not studying full-time/in a dedicated study, then you’d want to scale that down. Once you’re comfortable learning things and making excellent Anki cards, so you don’t forget them, increase your questions/day. If you’re making/doing excellent Anki cards, you might top out at doing 80-120 questions/day. However, while you will find people who (productively) do more than 120 UWorld questions in a day, they are often not doing Anki. In other words, they devote most of their day to QBanks.

How Many UWorld Questions Are There?

Want an up-to-date breakdown of how many UWorld Step 1 and Step 2 CK questions there are? Curious about how many questions there are in each UWorld Step 1 and Step 2 CK subject or system? Want to know how many UWorld questions have been added since 2018, shortly after Amboss arrived on the scene? Check out this article.

Concluding Thoughts

Having a generic answer for the number of UWorld questions per day is a recipe for disappointment and stagnant scores. Instead of obsessing about the number of questions you cover, focus on the amount of material you master in a day. You will give yourself a much better chance at doing more questions eventually. And most importantly, you will learn/apply more to your tests and future patients. How many questions do you think are reasonable to do in UWorld per day? What have you found to be the best approach for pacing yourself? Let us know in the comments!
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Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.

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