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USMLE Break Time Strategy for Test Day

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by Alec Palmerton, MD in Plan
USMLE Break Time Test Day Strategy

Are you taking your USMLE Step 1, Step 2 CK, or Step 3 soon and want to know how to use your break time? Do you wonder what you can do on test day to maximize your score? Need a last-minute reminder of what to bring to your test? Are you unsure how long each USMLE is and how much time to budget?

In this article, we will discuss:

  • How much break time you get for Step 1, Step 2 CK, and Step 3,
  • The simple step to get more break time on each USMLE,
  • Ways to take a break without risking running out of time,
  • A USMLE break time strategy to make sure you are at your peak, and
  • Much, much more

Table of Contents

When Can I Take Breaks?

You can take breaks BETWEEN each block of content. These breaks include taking pauses in-between case simulations on Day 2 of Step 3.

The critical thing to remember is that you CAN NOT take breaks DURING a block of questions.

How Much Break Time Do You Get on the USMLE Step 1, Step 2 CK, and Step 3?

For Step 1, Step 2 CK, and Step 3, there is 45 minutes of SCHEDULED break time. I say “scheduled” because each has a tutorial going over exam basics like how to fill in questions and the option of testing your headphones. If you skip the tutorial/finish it early, you receive the unused time as extra break time.

Here is a summary of maximum available break time for each USMLE if you skip the tutorials:

  • Step 1: 60 minutes for 7 hours of MCQs (8 hours total)
  • Step 2 CK: 60 minutes for 8 hours of MCQs (9 hours total)
  • Step 3:
    • Day 1: 50 minutes for 6 hours MCQs (~ 7 hours total)
    • Day 2: 57 minutes for 4.5 hours MCQs + ~3.5 hours case simulations (~ 9 hours total)

For those of you who want to know more about how each test day’s layout, here are more complete details:

  • Step 1: 45 minutes break time (+ 15-minute tutorial)
    • ~8 hours total: 7 hours of exam time (7 blocks of 60 minutes each, with each block typically 40 questions) + 1 hour break/tutorial time
  • Step 2 CK: 45 minutes break time (+ 15-minute tutorial)
    • ~9 hours total: 8 hours of exam time (7 blocks of 60 minutes each, with each block typically 40 questions) + 1 hour break/tutorial time
  • Step 3
    • Day 1: 45 minutes break time (+ 5-minute tutorial)
      • ~7 hours total: 6 hours of exam time (6 blocks of 60 minutes each, with each block 38-39 multiple-choice questions) + 50 minutes break/tutorial time
    • Day 2: 45 minutes break time (+ 12 minutes of tutorial split across two tutorials)
      • ~9 hours total: 4.5 hours of MCQs (6 blocks of 45 minutes each, with each block 30 items) + 13 case simulations of 10 or 20 minutes maximum

USMLE Break Time Strategy Principles

For all the USMLE break time strategies, I followed the same principles:

1) Break Time is More Valuable Later on Test Day

Most people will be more tired at the end of the test than initially. As such, I allot more break time for the latter part of each exam

2) Checking In/Out of the Room Can Be Unpredictable

Checking into/out of breaks (waiting in line for fingerprinting/emptying your pockets/etc.) is unpredictable, especially on busy days and/or if there are problems with the fingerprint scanner. For example, a friend took a break after his first block only to find that after he came back into the room, he’d lost 20 minutes. As such, I didn’t plan for break time between every block in case the check-in/check-out procedures were taking too long.

3) Short “Sit-In” Breaks Can Do Wonders Without You Leaving the Room

You do NOT need to leave the room to take a break. However, if you need a few-minute break, you can do a “sit-in” break where you don’t begin the next block yet, but simply sit at the computer. Even a few minutes can do wonders, especially if you feel anxious and need to take some deep breaths.

Step 1 Break Time Strategy

  • 60 minutes total break time: 45 minutes break time (+ 15-minute tutorial)
  • ~8 hours total: 7 hours of exam time (7 blocks of 60 minutes each, with each block typically 40 questions) + 1 hour break/tutorial time

Here is my Step 1 break time strategy. (Note there are seven blocks of Step 1 questions and 60 minutes of break time if you skip the 15-minute tutorial):

  • Tutorial: check that your headphones are working, then omit the remaining 15 minutes of the tutorial for use as extra break time
  • Do 2 blocks back-to-back, then 10 min break (if necessary, 3-minute “sit-down” break in front of computer in-between first two blocks)
  • 2 blocks, then 10 min break
  • 1 block, then lunch break (20-30 minutes; variable, can choose to take a lunch break at any time)
  • 1 block, then 10 min break
  • Final block, then done!

Step 2 CK Break Time Strategy

  • 60 minutes break time total: 45 minutes break time (+ 15-minute tutorial)
  • ~9 hours total: 8 hours of exam time (7 blocks of 60 minutes each, with each block typically 40 questions) + 1 hour break/tutorial time

Here is my Step 2 CK break time strategy. (Note there are 8 blocks of questions and 60 minutes of break time if you skip the 15-minute tutorial):

  • Tutorial: check that your headphones are working, then omit the remaining 15 minutes of the tutorial for use as extra break time
  • Do 2 blocks back-to-back, then 10 min break (if necessary, 3-minute “sit-down” break in front of computer in-between first two blocks)
  • 2 blocks, then 10 min break
  • 1 block, then 10 min break
  • 1 block, then lunch break (20 minutes; variable, can choose to take a lunch break at any time)
  • 1 block, then 10 min break
  • Final block, then done!

Step 3 Break Time Strategy

And here is my Step 3 break time strategy. Note that the standard Step 3 administration is over two days.

Step 3 Day 1
  • 50 minutes break time total: 45 minutes break time + 5-minute tutorial
  • ~7 hours total: 6 hours of exam time (6 blocks of 60 minutes each, with each block 38-39 multiple-choice questions) + 50 minutes break/tutorial time

Here is my Step 3 Day 1 break time strategy:

  • Tutorial: check that your headphones are working, then skip the remaining 5 minutes of the tutorial for use as extra break time
  • Do 2 blocks back-to-back, then 10 min break (if necessary, 3-minute “sit-down” break in front of computer in-between first two blocks)
  • 1 block, then 10 min break
  • 1 block, then 10 min break
  • 1 block, then lunch break (20 minutes; variable, can choose to take a lunch break at any time)
  • Final block, then done!
Step 3 Day 2
  • 57 minutes break time total (in practice, much longer due to case simulations ending early): 45 minutes break time + 12 minutes of tutorial split across two tutorials
  • ~9 hours total: 4.5 hours of MCQs (6 blocks of 45 minutes each, with each block 30 items) + 13 case simulations of 10 or 20 minutes maximum

Nominally, Day 2 of Step 3 is a marathon. However, in practice, because the case simulations typically end early, your day will often be shorter (and likely much shorter). Therefore, most people don’t need to worry about break time.

  • Tutorial: check that your headphones are working, then skip the remaining 5 minutes of the tutorial for use as extra break time
  • Do 2 blocks back-to-back, then 10 min break (if necessary, 3-minute “sit-down” break in front of computer in-between first two blocks)
  • 1 block, then 10 min break
  • 1 block, then 10 min break
  • 1 block, then 10 min break
  • Final MCQ block
  • Tutorial #2: you can skip the 7-minute tutorial to use as extra break time
    • Since most will end early for the case simulations, you can use the remaining time from each case simulation as a break. Otherwise, keep moving forward and enjoy finishing early.

USMLE Break Time Test Day Strategy

Other USMLE Break Time FAQs

Can I Get Extra Break Time?

Beyond skipping the tutorials, can you get extra break time? In fact, yes!

If you finish a block early, you will add the remaining time to your break time. In other words, if you complete a 60-minute block in 50 minutes, you can add the unused 10 minutes to your break time.

Adding to your break time sounds great in theory. However, few people finish their Step 1 or Step 2 CK blocks early in practice.

That said, for Step 3, particularly on Day 2, you will often have extra break time. This additional time is because the case simulations usually end early, and when they do, you get the remaining time added to your breaks. Day 2 for Step 2 often ends earlier than you’d expect (for many, it is much earlier).

What if I Take Too Much Break Time?

If you run out of break time on any of the USMLEs, it will reduce your time for the content. Specifically, it will start the next block and start the timer. Thus, it is critical to not run out of break time, since you will begin losing time for your exam.

As discussed above, to ensure that you don’t run out of break time, we suggest limiting the number of times you check in/out of the testing room. What’s one big difference between practicing taking a test with breaks at home vs. at the center? At the center, you have to account for time spent in line for fingerprinting, turning out your pockets, etc. If you’re unlucky and the fingerprint scanner isn’t working, the lines are long, or standard procedures take more time than normal, you may be stuck with too little time for your test.

For more information on recommended break time strategy, see above.

Need to Know What to Bring to Your USMLE?

Need to know what forms of ID are OK to bring to your Prometric appointment? Unsure of the best snacks for test day? Want to know the best test-day snacks so you’re at your peak, even if you’re addicted to coffee? Check out What Should I Bring to My USMLE at Prometric?

Concluding Thoughts

USMLE Test Days are stressful enough as is. You are taking a high-stakes exam that can affect the rest of your career. While you can expect a certain degree of anxiety, having a plan for how you’ll apportion your break time can help you feel more confident and in control.

What sort of break time strategy will you be following? What has worked/not worked for you in the past? Let us know in the comments!

Photo by Mindspace Studio on Unsplash

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.

Subscribe
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