UWorld (sometimes called “UW”) is one of the most widely-used question banks (“QBanks”) for Step 1, Step 2, and Step 3 prep. Formerly known as “USMLE World,” its popularity has led to a lot of dogma around how best to use it. Despite scoring 270 (99.9%ile) on Step 1 at Stanford, I made many mistakes using UWorld, partly by blindly following the “standard” advice. In this article, I’ll answer the most common questions surrounding the QBank. Plus, I’ll tell you the biggest UWorld mistakes and how to get higher Step 1 and Step 2 scores faster. (Even in a world where Step 1 is pass-fail).
Summary:
- UWorld has changed a lot over the past 10+ years (e.g., the number of questions has doubled, and the quality of questions has been diluted somewhat)
- The USMLEs have changed a lot (e.g., Step 1 is pass-fail)
- However, UWorld advice has largely stayed the same (e.g., “do lots of UWorld questions,” “repeat UWorld many times”)
- Most people are afraid of leaving the herd; those who can do so thoughtfully can improve their Step 1 and Step 2 scores faster
Note: this article was updated on 11/17/2023 to reflect:
- Step 1 being pass-fail,
- UWorld nearly doubling the number of questions over several years, and
- 10+ years of seeing others waste time making similar mistakes to my own
Table of Contents
Question #1: What is UWorld (or “Youworld”)? Why Is It So Famous?
tl;dr: UWorld is a question bank of USMLE practice questions. The quality has fallen in recent years. However, it is famous because it is still the best at mimicking the concept-application style of Step 1, Step 2, and Step 3 questions.
UWorld is a question bank (or “QBank”), composed of practice questions for the USMLE Step 1, Step 2, and Step 3. (It has also expanded into other exams; this article will focus on the USMLEs).
To do well on any exam, we must practice for it, right? This practice – and how we do it – is doubly important for the USMLEs. That is because the USMLEs are written as tests of concept application, NOT factual recall.
Unlike the exams most of us take in medical school, Step 1, Step 2, and Step 3 focus on applying medical principles. Thus, the question bank we choose significantly impacts our skills of question interpretation and concept application. UWorld is famous because it has traditionally been the best at mimicking the USMLE style of questions.
Question #2: Should I Repeat UWorld Step 1 Multiple Times? (Even At the Expense of Another QBank)?
tl;dr: UWorld is great for testing you on applying concepts you’ve mastered. However, rather than testing yourself using the same question 2-3x, use a fresh QBank. (Especially since UWorld has more than doubled the number of questions from when people started saying to repeat the QBank).
When I entered Stanford in 2009, the most common advice I heard was to repeat UWorld multiple times. At the time, UWorld Step 1 had fewer than 2,000 questions. Today, that number is nearly double! Yet all I hear students say is, “You have to do multiple passes of UWorld!!” Let that sink in. If doing a 2,000-item QBank twice is 4,000 questions, why would I do it twice if the QBank is now 4,000 items? I’ve seen that this multiple-UWorld-passes advice gets passed on as gospel because we’re afraid of deviating from “the path.” But why would people want to repeat UWorld? And why might that be a mistake?
Why Do People Say to Repeat UWorld?
Why does everyone tell you to repeat UWorld? The logic is alluring: UWorld is a fantastic resource. Therefore, doing it more than once will boost your score even further. If a little of something is good, then more must be better. Right?
A little bit of water is good for you. But excessive water isn’t necessarily better.
If Something Is Good, More Isn’t Necessarily Better
Ultimately, I realized repeating UWorld was a mistake when I ran into one problem: opportunity cost. Every repeated UWorld question prevented me from studying from a different question bank. Plus, I remembered so many questions that it gave me a false sense of security that shattered when I saw fresh NBME questions. The USMLEs and Shelf exams test your ability to apply concepts. So yes, practicing by doing QBank questions is critical. But as I discuss below, much of the benefit comes from seeing a question the first time. If you’ve seen a question – particularly recently – it’s easy to remember the answer without remembering the reasoning. Temporarily, you may boost your confidence by seeing higher scores. But that confidence can be shattered when you go to the exam and realize that the questions are written differently than you’ve practiced.
Do UWorld Only Once
UWorld questions are as close to the real thing as possible. Because they’re so close to the real thing, I STOPPED repeating it. Wait, what? A considerable challenge for Step 1 and Step 2 is questions you have never seen before. Some you may have never even thought about. That is the secret to scoring 99.9%ile on Step 1 or Step 2. You must learn how to reason through questions you’ve never seen before. Even if you hope to pass Step 1, knowing how to apply concepts to novel questions can help push you over the top.
How to Prepare for Questions You’ve Never Seen Before
How can you get questions right you’ve never seen before? By practicing questions that you haven’t seen before. This might seem obvious. So why do so few people do it? UWorld is similar to USMLEs. However, that does NOT mean your USMLE will be exactly like every UWorld question. How many students claim their test was nothing like First Aid/UWorld? Lots. But if UWorld is like the USMLE, why are so many students blind-sided? Because they go in thinking the content of the test will be identical to UWorld. Instead, expect the unexpected. Use UWorld (or other QBanks) to simulate never-before-seen questions. Full disclosure: I used Kaplan’s Question Bank first. My NBMEs were in the 250s before I even started UWorld. (I only did 2 Qbanks total). I started to repeat my UWorld questions but stopped when I realized my scores were artificially inflated by remembering questions.
Question #3: Can I Repeat UWorld for Step 2 After Shelf Exams?
tl;dr: yes, but check and ensure you aren’t remembering questions from before.
The one time I HAVE found repeating UWorld questions helpful is if you’re studying for Step 2 after preparing for Shelf exams. Why? Most people use UWorld to study for the Shelf exams after each clerkship. Since clinical rotations last more than a year for most US med students, it will have been many months since they saw specific questions. Especially if it’s been 6+ months since you did them last, they will again feel like “new” questions. And it’s vital that questions feel new. High Step 2 scores depend on your ability to interpret questions. For example, you need to know why a patient with a deviated trachea has hypotension, jugular venous distension, and clear lungs. (E.g., tension pneumothorax with signs of right-sided heart failure). If you remember the answer, you can’t practice putting all the pieces together, a skill you’ll need on the actual exam. So, feel free to repeat UWorld for Step 2 if it’s been many months since you did most of the QBank. (Ensure you aren’t remembering the answers to questions.)
Question #4: When Should I Start Using UWorld?
tl;dr: UWorld has nearly doubled the number of questions; it’s easier to start earlier without repeating them later.
In the olden days, UWorld Step 1 and Step 2 each had fewer than 2,000 questions. Now, each has nearly double that number. To make sure you would only do each QBank once, it was often better to start later in your studies. However, now that there are many more questions, you can start much earlier! As a first-year medical student, you may not be able to answer very many items. However, even doing a few QBank questions daily along with your classes can help, especially since most med school exams are memorization-heavy. Similarly, for Step 2, it is good to start as early as possible. Most of Step 2 will be based on Shelf exam content anyway. As such, the better you prepare for your Shelf exams using UWorld, the easier it will be later.
Question #5: How Similar is UWorld to Step 1 or Step 2?
tl;dr: the “It” factor for QBanks is how well they mimic the NBME style of questions. UWorld is worse than it used to be…but better than the others.
UWorld has always been a reasonable tool for learning. However, what caused it to stand out was that the questions did an excellent job of mimicking the style of Step 1 and Step 2. Does UWorld still do a good job of mimicking NBME-style questions? I’ve seen UWorld questions evolve over the past 15+ years. In my opinion, the questions are worse than they used to be at using the NBME style. (How can you double the number of questions without adding more “filler” type questions?) That said, they are still better than the alternatives, even Amboss or Kaplan.
Question #6: Why Do Some Say Step 1 or Step 2 Are Nothing Like UWorld?
tl;dr: the USMLE test writers are VERY clear: they are testing your ability to apply concepts, NOT memorize facts. If you approach Step 1 or Step 2 like a list of facts to be memorized, you may find your test feels NOTHING like UWorld. If you apply concepts >> memorizing details, the exams will likely feel familiar to UWorld.
Why do so many students who take the test say it was nothing like what they’d prepared for? They say it wasn’t at all like their UWorld questions. But how do others (including myself) claim it was similar to what they’d expected? I’ve worked with multiple students who have failed Step 1 before coming to me. These two groups’ experiences differ because of their beliefs about the test.
UWorld Repeaters Often Believe USMLEs = Tests of Knowledge, Not Application
The students who’ve failed their USMLE often feel that the exam is a test of facts. They think repeating UWorld and First Aid is the best way to accumulate those facts. The high-scorers know covering everything they could be tested on is impossible. Instead, they know that the point of the exam isn’t knowledge. Instead, scoring high on the USMLEs requires the application of principles. High-scorers recognize that memorization itself is insufficient. They must apply that knowledge to interpret the test questions correctly. (To read How Are USMLE Questions Written? 9 Open Secrets for Impressive Boards Scores, click here). The latter group sees the QBank merely as a means to an end. To them, it’s a practice ground to hone their reasoning skills for the test day. In my experience, this group does much better.
Repeating UWorld questions makes it harder to answer items you’ve never seen before.
Question #7: Amboss vs. Kaplan vs. UWorld?
tl;dr: UWorld is better at mimicking NBME-style questions. Amboss is better for delving more deeply into related topics.
As mentioned before, UWorld is still the best at mimicking NBME-style questions. That said, it is just a QBank. Amboss, in particular, has a more extensive “knowledge library” that you can use to cross-reference and learn things in greater depth. Personally, I still recommend UWorld and using First Aid and other resources to learn the topics in greater depth.
Question #8: Should I Wait to Do UWorld Until Right Before My Exam?
tl;dr: I recommend UWorld as the final QBank before your test to practice applying concepts to novel questions. However, since many more questions exist, you may not have to delay starting.
Should you save UWorld for last? Again, like much of the dogma, the answer will depend on what you believe the test to be. To you, are the USMLEs a test of knowledge? If so, then doing UWorld right before your exam may or may not be as important. What if you think the USMLEs test your ability to apply knowledge to questions you’ve never seen before? You will likely want to use UWorld as the final question bank before you take your test. (See above; UWorld is the best QBank I’ve found that mimics the real test conditions). If it isn’t already abundantly clear, I fall in the latter camp. QBanks are a learning tool, not a repository of facts. Use them to learn critical information as well as how to apply it to novel situations.
Concluding Thoughts
I wrote the first version of this article nearly ten years ago! In that time, there have been many changes, including:
- UWorld nearly doubling the number of questions,
- Many credible alternatives arriving (e.g., Amboss),
- Step 1 moving to pass-fail, and
- Much more
What I find surprising is that the advice students still give each other is almost identical to when I entered medical school in 2009. “Just do UWorld!” “I did multiple passes of UWorld – you should too!” Ultimately, your preparations and use of these resources will depend on your fundamental beliefs about the USMLEs. As a medical student and USMLE tutor, I worked under the assumption that Step 1 wouldn’t be a receptacle for me to regurgitate UWorld/First Aid knowledge. Rather I saw the exams as a series of carefully constructed questions that would test my ability to integrate and apply pathophysiologic principles. And since the NBME writes questions to test your ability to apply concepts, it’s unsurprising that those students tend to do better.
What do you think? Are you still planning to repeat UWorld twice? Other thoughts? Let us know in the comments!
Photos by Jasper van der Meij, NeONBRAND
91 Comments
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Do you recommend Kaplan or Uworld qbank for studying for step 3 after a previous failure?
Probably UWorld, assuming you haven’t used it excessively/remember all of the answers. But the bigger issue is to address your APPROACH, since which QBank you use is much less important than how you use it. You can schedule a consultation to discuss this more here: https://yousmle.com/consultation
Dr. Palmerton
If you dont recommend doing uworld twice, what is the next best Qbank. I have used Amboss but, kinda question it after doing it for awhile.
How did you learn from your mistakes and how did you know what to base Anki cards on if you didnt even go over your incorrect questions (#1)
Hey! Does it make sense to be done with uworld once and then (while you solve nbmes and review them) purchase Kaplan Qbank and solve questions You’ve not seen before till your exam?
Hello Dr. Palmerton
Good Morning, I just wanted to inquire about the amount of Psychiatry cards in my Step 2 CK deck. Right now it is 28 cards is this accurate. Thank you, looking forward to hearing from you.
Kind Regards,
Anji
What do you believe to be a good “repository of facts” for Step 2?
Step 1 prep advise: I can’t seem to find the answer to this online anywhere but what do you think about using Board Vitals question bank instead of UWORLD for Step 1 prep. Board vitals helped prep better for shelf exams since we do major clinical year before taking step 1 but was curious on your thoughts. Thanks .
Hi Jaya – thanks for your e-mail. Unfortunately I haven’t used the Board Vitals QBank, so wouldn’t be able to give you an honest comparison with UW. I have found UW to be invaluable for preparation, though, so I wouldn’t use anything instead of it – perhaps in addition, if you found it particularly useful.
Alec
In your study period, how many questions did you go through a day? time spent reviewing explanations? making cards? And how did this change as you went forward? Do you have a rough guideline on how long these things should take? sometimes I get through only 20 questions a day!
Could you post a sample daily schedule, I know it varies based on a lot of things, but just want a general idea. Lunch,/dinner exercise, caffeine, days off misc factors would be nice to see as well.
Sir, I am Akash, now at the end of 1st year. What book you suggest for effective learning in physiology and biochemistry?
You can find my recommended resources here: https://www.yousmle.com/resources/
There are no great books for biochemistry, unfortunately. I have a large amount of video content available for biochemistry for group tutoring students, which you can find here: course.yousmle.com
what do you think of using guyton and hall textbook of medicala physiology as a study tool?
Hi Alec, I’m so sorry if you answer this question in another blog post but I wanted to ask you how you recommend interpreting the percent correct score I get after for each Uworld question block (not the full practice tests but the Qbank questions). I am scoring above average but I don’t know how to gauge it beyond that. Also, do you have a post on a recommended study schedule? I made one that has me rewatching pathoma and sketchy as well as doing DIT, 2 uworld 40 question tests a day and reviewing pharm/micro daily. I am very nervous about what I should be doing. Like, do I schedule time to actually memorize things? I am worried that 2 weeks into studying I will realize my plan is not the best way to prepare and then I will have wasted a lot of time that I don’t have. I just want someone to tell me what to do so I can then go do it haha. Any advice you have is very much appreciated.
Again, what matters less is your schedule, per se, and more the approach, whether you are mastering material, and learning how to apply it. Most students struggle with this, but personally, I think watching a lot of videos is unlikely to help you with mastery.
Hi Ale. I’m Jorge From Venezuela and I would like if you can, post some tips about to “How to Approach Uworld as a Book study”. B/c in my case I take to much notes that It takes me 2 day to correct 1 block of 40 questions and brain ends saturated w/ to much information. thanks.!
Hey !!!
Heard about your site from a Youtuber. Wondering if you have cards specifically for Physiology, Neuroscience Immunology and Genetics. Thank you!
-A. Haji Datoo
I do indeed! The physiology cards are all spread out in the different organ system blocks, but neuroscience, immunology, and genetics all have their own sections. I ask which YouTuber you heard about the site from?
Hey whats up? Thanks for taking time to read this. Could you please guide me in taking USMLE Step 1. I am confused due to the amount of resources there are. I am an IMG, but my school is not USMLE oriented, so the bulk of my studies comes from reading sources. What would you recommend i should do. I am a 4th year medical student and I am in a 6 year MD program in Europe. I was thinking of taking the exam next year(2017) in September. I am thinking of reviewing all my BRS books and FA. But that will take too long and Idk if its worth the effort of investing that much time into this review. I would really appreciate if you properly guide me in this. Thanking you in advance.:)
You can find some of my general advice on the topic in the table of contents: https://www.yousmle.com/table-of-contents/
If you’d like individual/group instruction, you can e-mail me at alec at yousmle.com
Hello, how can I purchase or download the anki flashcards? It sounds like they could be a wonderful tool for ny step 1 prep…
yousmle.com/step1anki
Hi Alec!
I’ve been using your cards for a couple days now, and have already begun appreciating how understanding the WHY can really help both understanding and retention!
I had a question regarding how I should use QBank along with the Anki cards. I’ve been doing the Anki cards by system, and doing UWorld along with system as well. (I have already completed UWorld in its entirety in random/tutor mode, but had to push back my exam as I wasn’t scoring well on NBMEs).
Would you recommend doing cards and questions by system as the best way to go if I need to bolster my knowledge of concepts?
I do feel it’s helping me make sure I have the concepts down, but at the same time, I can’t help but think that doing UWorld randomly is better to simulate the exam!
Hi, my name is Jesus from Mexico city, im an IMG and I want to get into radiology. I have extended my elegibility period for april-june 2016 for my step 1 because I made the nbme 13 and a u wolrd self assesment last week and I got 215 and 219 respectively, so, what do you recomend me to do to get a 240+, I have readed all the Kaplan books once, finished the uwolrd twice and have Readed the first aid 2015 twice.
Thank you.
The key is to move beyond thinking of how many pages you’ve read, or what lectures you’ve read. The key is to understand connections and how to apply them to your exam. I’d recommend reading the article below where I share some advice on that exact subject:
https://www.yousmle.com/nail-fundamentals-usmle-step-1-nbme-practice-exams/
I liked your page and i agree with you completely ,,,,i think the test depend on how you improve your strategy to deal with the question more than the solid memorization which is unfortunately what i learned in my medical school in Iraq..anyhow ,,,do you agree with the fact that Uworld is completely a learning tool and thus should never be used as estimation for your score in exam ?
Thank you so much for your assessment, and your comments! In general I would agree, that generally UWorld is better as a learning tool, and should not be used as an estimate of your score. How many times have you seen people in USMLE forums say that they had a very high average on their question bank blocks, only to have a very disappointing USMLE score?
I’m using the your step 2 CK deck..I used your step 1 deck too and I liked it..Is there any suggestions for preparing for step 2 ck? Most of your email seems to be relevant to step 1. Thank you.
Great question, and thank you for your kind words about the Yousmle.com Step 1 deck. Honestly, the approach is very similar for learning Step 2 material. I would recommend spending more time on question banks, and focusing on learning appropriate interpretation of clinical symptoms and signs. Step 1 is more difficult for the knowledge and being able to make connections, while Step 2 is difficult in differentiating between similar diseases that give similar presentations.
hello Dr.Alec
i just finished my 2nd year in an Indian Med school.I am planning to give step 1 in 6 months..that much time i have for preperation…
i am going to use following books
FA2016
1.Rapid review pathology
2.CMMRS for micro
3.High yield series for anatomy
4.BRS physio
5.Kaplan lectures notes and lectures for Pharmac and biochemistry
i am confused about which source is best for behaviuoral sience?
i am also thinking to buy ANKI deck from you….should i get that after i finish single reading or it would be wise to get it now…and use it from initial phase of preperation?
also should i buy UWORLD 6 months subscription and use it from initial phase for learning purpose or after i finish single reading?
I really appreciate you taking time reading this!
please help me!
Thanks
Honestly, spaced repetition is best if you get it earlier. If you plan and getting the Anki deck, I would get it as soon as you can, so that you can benefit from the greatly improved retention, particularly since you have such a long time frame.
As far as UWorld, I would honestly probably wait to use it until you are closer to your exam. I am not a fan of doing it twice or more like some people have recommended, mainly because I think the benefit of using it is mainly in practicing doing questions for the first time, since that is exactly what it will feel like on the day of your exam. If you want to do any questions early on to get a sense of the test, I would recommend doing the Kaplan question bank.
Alec
Thanks a lot for your reply
Do you think my review material is correct? anythin you would like to add/subtract
i will let you know about Anki cards soon
Thanks
I’ve never used HY for anatomy, so can’t comment on it, and I prefer Costanzo to BRS phys if you’re going to use it as a reference (this is a minor point, they are the same author), but otherwise those look solid!
Thanks a lot!! 🙂
Absolutely – best of luck!!
Alec, I Appreciate Yourselflessness. I Believe You Have Been A Blessing To All The Students of Medicine. This is why I am reaching out to you today. My Question for You Sir : What should i go over now that i am to take USMLE STEP 1 Dec. 30 2015? In 2 days I will finish Uworld. I Have done DIT 288 videos and the ANKI card you recommended.
Thank you so much for your kind words, and question. I hope that my advice is not reaching you too late. I best advice is to do more questions, and to learn the topics that you are weakest at, but focusing on a manageable amount of information every day.
hello doc.
i have a serious problem, I’m an IMG and my Step-1 is in less than 3 months
I’m doing Uworld for the 1st time and first aid 3rd time along with flash cards
I keep on getting 65-45% on every system-wise block that i do
I’m starting to panic and feeling down and
my friend is preparing with me and his Uworld is 90-75%
i feel like I’m doing something wrong. I’m afraid to take NBME because if i fail i’ll be frustrated
The best thing to do is to take an NBME now, to see where you are, to get an idea of whether you are improving your scores are not, which would let you know how effective your studying is.
Hi Alec,
I’m in the later part of my first year in med school and my goal is to complete one kaplan qbank and one lap of UW qbank. I wanted to know how many questions should I be doing per day or week or month?
Honestly, I’m not a huge fan of doing too many questions that early. You could do both in a 2 month period (this is what I did), so I wouldn’t worry too much about doing too much early.
Hi Alec,
this is great advice, thank you! I was wondering if you could tell me, how exactly do you reason through the question? I have been doing sooo many question banks and I have studied A LOT but I just see no improvement on my NBME’s. I must be lacking the integration and application skills or I may just not have understood the connections well …
Would you have any tips?
Thank you
Hi Sarah,
Thank you so much for your question. Certainly, a lack of integration and application can certainly trip you up, and to prevent you from improving your scores. My best advice is to both slow down when you are learning topics, so you give yourself enough time to learn them appropriately, as well as to make it your mission to understand what each sentence means in every NBME or question that you do. You won’t be perfect, but if you improve a little bit every day, you can certainly make a lot of progress.
Hope this helps!
Alec
Hey Alec–
I’m getting ready to take step 2 ck and was wondering if you had advice regarding doing the UWORLD questions. Would you recommended doing random sets of 44 or Taylor them by subject?? Any advice would be greatly appreciated.
Thanks!
Typically I’d recommend random, unless you’re scoring very low (NBMEs < 200) and you absolutely need to review by topic.
Hey Alec–
Any suggestions on how to tackle
Step2 CK as far as if I should do uworld questions as random sets of 44 or by subjects? Any advice is greatly appreciated!
Thanks,
Angie
Hi Alec, I’m sitting at 11 days away from my Step 1 and looking for advice on tackling the last week. I will be finishing DIT with 9 days to go. I still have 1500 questions left to go through on UWorld. In my last week I was hoping to get through First Aid (80 pgs/day), Pathoma/SketchyMicro (4 hours a night), and 80 UWorld questions per morning. Would I be better off scrapping First Aid and Just doing UWorld Questions from 8 AM – 4 PM each day. (on average I can get through 20 questions/hour). *I’ve never felt like I could just read and comprehend. So any extra time each day would maybe be spent on a topic I feel the weakest on.
Hey! I hope your exam went well. This may be late, but in general, when you are that close to your exam, typically it’s best to do more questions rather than passive learning. I hope this can help you for your preparations for self exams and for Step 2!
Hi Alec,
My Step 1 exam is 13 days away and unable to push it back any further. In light of this, I had two questions:
1. Would I likely gain any benefit from your ANKI cards at this stage? Certainly, my big weakness I feel is applying basic pathophysiological principles to new questions.
2. I know that U world is supposedly the best question bank to use but haven’t gone through it already, I wonder would I be better off getting Kaplan because at this stage I feel I’m just recognising answers without having to really think about it.
Any help or advice would be much appreciated.
Thanks.
Sorry for the delayed response – hope your test went well! Studying pathogenesis to presentation at any stage should help, as should spaced repetition, although in general the longer the timeframe, these will be even more useful.
Hope your exam went well!
Alec
Hi Alec,
I wasn’t quite sure where to post this. I was wondering do you have answer keys and explanations for NBME 15, 16, 17? Or any reliable sources you would recommend? Im trying to go through the exams and for things I’m unsure about there are a lot of contradicting answer keys and discussions online.
Thank you
– H
I don’t, unfortunately. Typically I go over this with students that I tutor, to help them to understand any issues they are having with interpretation of the questions themselves. I don’t know of any resource like what you’re asking for, however, presumably because it would likely break certain copyright laws.
hey alec, thanks for the reply., my problem right now is that as I am typing things into anki, I recognize that my time might be better spent by basically putting everything from first aid into anki;
there are other decks and flash-card services like USMLE flash rx that offer that service. so is there any benefit to doing this? keep in mind i only have 3 months so it’s not like i have a lot of time to spare.
I don’t necessarily agree that putting everything from the First Aid into Anki is the way. The most important thing that you can do is to understand the material, not necessarily memorize facts, like so many other services out there.
I suggest the following article:
https://www.yousmle.com/5-keys-rock-usmle-step-1-anki-spaced-repetition/
Alec,
Hope all is well.
I’m getting mroe intot he Anki game, but it’s sort of tough to really master it.
My first quesiton is how many anki questions do you do a day? How many new ones do you do a day?
And, how do you interpret U-world scores?
I’m scoring pretty low right now. I’m probably averaging 40-50%.
I also don’t know how ot use the q- bank. I basically was doing it by systems, and now I am slowly reverting to mixed blocks.
I’ve discovered that i learn best with pathoma/firecracker, but the anki stuff is almost getting excessive. I am trying to do what you did with your pathogenesis to presentation cards, but I don’t know what’s a realistic goal to set.
I basically outlined all of pathoma into an excel file and iam going to import it into anki.
Any thoughts?
Best
At the peak, I did about 300 to 400 cards in a day of old reviews, and roughly 40 new cards in a day. I don’t put much stock in UWorld scores, and go more by NBME scores. If you are scoring below passing, I would still study by system. Honestly, it sounds like you are trying to do too much, and should probably pare down some of your resources. I would not do both Firecracker and Anki, and would choose one or the other, otherwise you risk overwhelming yourself by trying to chase way too many rabbits.
I’ve always had a hard time passing steps. i’m studying for step 3 right now. I’m scoring about 50% correct each time I do 44 timed question blocks. That puts me at the 5th percentile. Do you know how that compares to an actual Step 3 score?
I know there isn’t a 1:1 translation between UWorld and a predicted true score but I was hoping you could give some insight as to what a passing score on Step 3 and what kind of percentages/percentiles I should be seeing on Uworld.
Any insight would be super helpful.
Hugo
Hi Hugo!
Thank you so much for your message. Unfortunately, there is no perfect way to predict what your score will be particularly when using question banks. The best thing to do is to use an NBME practice exam (for Step 3 I believe they are “Comprehensive Clinical Medicine”), which should give you a good idea of where you would score if you take the test now.
Best of luck!
Alec
Alec, thank you for all your insights. It’s definitely a breath of fresh air! I just have some concerns over doing the UWorld- review book approach for Step 2 CK…. I’m using Master the Boards and I find that it’s a bit more confusing to do questions first before looking them up. Would you recommend using another review book for your method? Like FA for Step 2 CK? Thank you so much!
Thanks so much for your message! I personally used UWorld for Step 2CK, doing questions and studying from them, and have known many people who have successfully done that strategy. If you find yourself needing more foundation, I used First Aid for Step 2 CK as a reference, which I found to be useful.
Hope this helps!
Alec
hey alec,
how do you recommend using the q – banks? i’ve been using them by discipline – ie neurology, etc. but ia lways do timed. should we do more mixed mode stuff?
Great question. It really depends on whether you are scoring well already, whether you are close your exam, and what your overall goals are. If you’re scoring above 200 or 210 on your NBME practice exams, I would recommend doing mixed blocks. If not, particularly if you have more than a month until your exam, it might be better to do subject specific so you can hit your weak areas in a more concentrated fashion.
Best of luck!
Alec
Hi Alec, thanks for putting together the website. It’s great! I’m going to start my first year of med school soon and would like to hear what advice you have for me on preparing for the step 1? What do you recommend for first year students? Should we do UWorld questions as we cover different subjects in class? Make anki cards for each class so when it comes around for our dedicated study time, we have more time to do qbank questions? Thanks!Matt
Hi Matt,
Thank you so much for your message, and for your kind words. In general, I do not recommend doing question banks during your first year. I know that a lot of people will tell you that doing Q banks early is critical etc., but in my experience these are also people that do not use spaced repetition, or at least do not use it effectively. If you use spaced repetition well, you should only have to go through a question bank one time.
Some of your approach will depend on how important your class ranking is, since the more important it is the more I would focus on your class work. That said, I still focused a lot on my coursework, even though Stanford is pass fail throughout the preclinical years.
My best advice to you is to use your coursework as a supplement to your studying for Step 1. One of the most difficult tasks during the first two years of medical school if you figure out what is most important to study. It’s easy to say that you should learn the fundamentals, make connections, and learn things in as much depth as you can. It’s a completely different thing to put that into practice, though. To do this, I would use First Aid as a target for the information that you need to know. Use your classes to understand the First Aid material well, since FA won’t give you much depth or mechanisms, but will give you a good idea of the kinds of information that you will be tested on for your Step 1.
Also, remember to take a deep breath, and relax. Medical school is one of the most challenging times, but can also be greatly rewarding. You are in for quite a ride. If there’s anything I can do to help, please contact me again on the website, and I will be happy to help in any way possible!
Sincerely,
Alec
Thanks Alec for the response! I will keep in touch. Good luck in your future studies and endeavors!
Sounds fantastic. I definitely look forward to hearing from you more as you progress through your career!
Hi yousmle, this blog is amazing… How I can get your complete set of anki’ cards???
Hi Tamara, thank you so much for your message! I have to Anki decks for sale, which you can purchase from the links at the top right of the website! Thank you again!
Hi Alec, I’ve read a few of your blog posts but can’t seem to figure out your general timeline of balancing coursework and board studying. I recently started my 2nd year and am thinking of switching over to dedicating the first half of my school’s 3 week test cycle on First Aid, DIT, Pathoma, question bank, etc, then looking at my school’s lecture slides to study for the school exam. Then a few months out to Step 1 in June focus more on Step 1 materials. Or did you focus on courses only, then started studying a lot for Step 1 in March, as that is when you took your first practice test? Thank you all this great information on your site!
Hi!
Thank you very much for your message. I did not use DIT, and Pathos was not a known resource when I took Step 1, so really I just focused on my coursework for the majority of the time, and made sure that I UNDERSTOOD as much as possible from First Aid as I went along. I think that it is sufficient to begin your studies for Step 1 during your dedicated study period, as this is what I and many others that I know did. The most important thing is is that you take the time to improve your ability to APPLY that knowledge during your dedicated studying, not simply focusing on facts.
Hope this helps!
Alec
Hi Alec,
Thanks for all the helpful information. I am taking my STEP1 in less than 6 weeks and was wondering what you think about doing Qbank blocks on random vs by topic? I have been going back and forth on which approach to use as I feel like sometimes on random I am not able to really learn the information as well. However, I know that I am not really testing “what I know” if I am sticking to a specific topic every time I do a block and then not coming back to that topic for a while.
Any advice is appreciated!
Hi Heather,
Thank you so much for your kind words and question. In general, I exclusively did questions on random, for the reasons you stated – it is more realistic to the real test, as I found that I could just eliminate particular answers just because they weren’t in the right block (e.g. eliminating pulmonary hypertension as an answer simply because I was doing a cardio block).
That said, my philosophy has shifted over time as I’ve been working with students who are at varying points in their studying. If I could go back, and if I had a lot of gaps in my knowledge, particularly if those gaps were concentrated in a handful of subjects (e.g. if I didn’t know a ton of cardio, neuro, and renal topics well, but was comfortable with most of the others) I would probably recommend to do subject-specific blocks in those weak topics, since I would be immediately testing myself on gaps that I’d filled, as opposed to waiting around for similar questions to come up again in a random block. I would just make sure that 2-3 weeks out, I was doing random blocks again.
Ideally, assuming you’re using USMLE World right now, if you were to do subject-specific blocks in a particular subjects, I would probably use Kaplan blocks, so as not to “imbalance” the blocks that I have remaining. This is a personal preference, but I would hate to do all of my cardio questions, only to switch back to doing mixed blocks and not see any cardio questions after I’d spent all of that time learning it. Plus, Kaplan is convenient since they give you the First Aid pages, and don’t block copy/paste when you’re doing it, which is nice if you’re making/editing Anki cards.
Hope this helps!
Alec
Hello,
Great post, I am taking your advice and getting through more questions via integration and application v. passive reading/”active” memorizing. How many times were you able to get through First Aid during your study preparation? I was unsure how beneficial questions would be v. numerous FA read throughs? I will be able to finish it 1-2 times MAX… maybe 1.5x. I am not sure how to most efficiently manage my time, my exam is in 3 weeks. Thanks!
To be more specific. I have been through UWORLD once and I have been through FA once… now I need to balance between re-doing UWORLD, using my KAPLAN Qbank, and re-reading FA thoroughly (# of times would depend on my question strategy). I would appreciate any advice you have!
Hi Forever,
Thank you so much for your great feedback and fantastic question. I actually am finishing up an article that I wrote in response to your question, but it’s not done. I did, however, want to respond ASAP given your short timeline. I actually never finished First Aid even once, and definitely didn’t read through it multiple times. My goal was to make sure that I learned it well enough the first time that I never had to go back to re-learn those things. When I had 2-3 weeks left, I was still focused on learning fewer subjects well, rather than trying to cover as much material as broadly as possible. Information without much depth never seemed to help me much, as well as students I have tutored.
Hope this helps! I’ll be sure to update this when I finish the upcoming article (sorry, residency doesn’t lend itself to updating this blog a ton other than responding to comments, haha).
Alec
Hi Forever,
Just wanted to update you: I just published the new blog post here . Thanks again for your question, and I look forward to hearing your feedback on the new article!
https://www.yousmle.com/first-aid-for-the-usmle-step-1-worst-mistake/
Alec
Hey there!
Outstanding blog, seriously! And very useful advice as well. I was wondering if you can share the copy of your study schedule for Step 1 ?
Hi Stylish – thank you so much for your kind words and fantastic question. Â I hope to write an article about this at some point, but in the meantime, here are my thoughts:
I made a schedule, but never really following it. Â I never really did subject-specific days, as I mentioned previously, but instead used random blocks of question bank questions to make sure that I knew the whys/hows of the conditions in the questions.
Hope this helps, and I look forward to hearing from you more in the future!
hi !! alec
the anki decks on micro-virology & jaundice are amazing !! absolutely indispensable !!
thanx a lot….im also going through micro book
“How the Immune SystemWorks”, its really cool,
wraps up stuff pretty amazingly!
your post on “Could You Connect Conjugate Vaccines and ABO Incompatibility for the USMLE Step 1?”
is really eye opening especially the clarity it gave regarding
A B antigens=carbohydrate, so IgM& Rh=protein = IgG” is really great
(i always knew it was IgM & IgG butdidn’t know why)…
since im an IMG….. theres not whole lot of time for me to do immunology,
so i’m just wondering if you could
upload decks on entire immunology…it would be of immense help.
thanks in advance .
good day!!
Dear Jordan,
Thank you so much for your clear, and fantastic feedback! I’m thrilled to hear that you found the USMLE Step 1 Cheat Sheets useful, particularly the one on conjugate vaccines, as well the Anki decks.
I’m always looking for more ways to help, and I will definitely try to include more Immuno cards in my next giveaway!
Thanks again for the feedback – I look forward to hearing from you again in the future!
Take care,
Alec
hi !!
alec,
ur blog is amazing,
all myths busted!! i was looking for help when i stumbled upon your blog,
u r an angel!! your advice helped me significantly advance my preparation&
use my grey neurons & application skills like never before,
i can see the results instantly!!
thank you soooo much for doing all this, i really mean it,
im also eagerly waiting for your future posts…
send you my heartfelt best wishes…
have an awessome life !!
Hi Jordan – thank you so much for your message! I really appreciate you taking the time to write and share your thoughts with the community. It really is quite amazing when you can actually FEEL yourself improving, particularly in your ability to understand and explain the human body. I look forward to hearing more feedback about the site!
Take care,
Alec
First of all, thanks a ton for the articles and the blog. Its awesome !
I had a question – Did you make cards out of the Educational points in U World and Kaplan QBank both or just U World ?
Thanks for the feedback! Â Great question – I made cards for both QBanks, mainly because they tended to focus on different information, and one gave better explanations for some conditions than others, and vice-versa.
Just took my Step 1. I wish I had done spaced repetition earlier; only started doing it after I read your blog. Do you think you could do a blog post on how you studied (books used, etc) during clinicals for the shelfs and step 2ck/cs? Thanks.
Hey Sidney – congrats!! Regardless of how the test itself felt, I’m sure it felt nice to be done and move on with your life!
You read my mind re: future plans on blog posts – using Anki/spaced repetition is certainly useful for clerkships, and I would love to add more articles re: how best to balance studying w/ life w/ clerkships. Thus, thank you for your comment, as the more interest I can see in such articles, the more I want to write!
In the meantime while I prepare future articles/get ready for the start of the new year, I can say that I carried over my general approach to doing questions first (usually UW), then studying off of the explanations later. For Step 1, some people make all of their cards based on FA/other resources FIRST, then do questions later, but they quickly find on clerkships that this is untenable. It is virtually impossible to make all of those cards before getting through a reasonable number of questions before you have to take your shelf. Instead, I just did questions first, then studied the things I got wrong, and made cards to make sure I never made the same mistake twice – basically, the same approach as with Step 1.
Hope this helps! You always have such thoughtful contributions, and love to hear from you!
Take care,
Alec
Hi Alec
First I’d like to say what a great site! It’s fantastic to see a past medical student giving as much valuable information as you are.
I’m a UK clinical student just starting my clerkship. Really looking forward to your upcoming article on this. How did seeing patients fit in with your learning for shelf exams? I’m currently choosing a condition a day, using different resources to understand it and trying to examine specific patients then having a power Sunday of creating anki cards that I review everyday. I think I prefer the Do questions, read, make cards though instead, seems more interesting.
Also I’m assuming any qbank would suffice. I think our Oxford clinical handbook is similar to first aid.
Thanks very much
K. R
Just to clarfify, I don’t intend on sitting any Step exams. This is just for my first year clinical shelf exams. Struggling to find a parallel UK Qbank with explanations as good as the USMLE World Qbank!
Hi KR,
Thank you so much for your message! It’s hard for me to know exactly what the best QBank would be, since I went through the American medical system. However, the strategy of doing questions, reviewing them, making cards so you never forget them, and doing your cards works regardless of the question bank. I did this with more than just USMLE World, and used it for every other question bank I used, with similar results.
Best of luck!
Alec
Thanks for getting back to me with the sound advice 🙂
Following on from this, let’s say I do a question r.e. a specific diagnostic test for ‘disease X’. Would I then study this particular diagnostic test only or would I study the whole of ‘disease X’ including presentation, management etc. in my textbook?
Sorry if this seems really picky but it will make a big difference time-wise. Shall I just trust in my question bank that it will cover all aspects of the key diseases?
I also noticed on your Facebook page that you have some new content to those on your newsletter. Unfortunately I have only just signed up to the newsletter. Was it by any chance on the topic of clerkships or work/life balance? – Both 2 interesting topics that I’ve noticed you have in the pipeline.
Thanks very much again for your help, fantastic work.
K.R
Thank you so much for your kind words. You will likely drive yourself crazy if you try to learn everything about every single disease you study. Instead, I suggest that you use First Aid as a target of the information that you need to understand. First Aid will let you know what knowledge you need to have, and the goal is for you to understand the why’s and the how’s of those diseases and the information. Best of luck!