Studying for the USMLE can be one of the most daunting tasks a medical student faces. USMLE scores play a huge role in the residency application process, and are one of the foremost factors that residency program directors examine when evaluating applicants. To ensure that you score well on your board exams, studying has to be a priority, but this can be challenging when there are so many resources, textbooks, question banks, and prep courses out there. Where do you start?

In part one, we covered some strategies and resources recommended by Dr. Michael Mehlman, a pioneer in USMLE preparation and co-author of the popular textbook First Aid for the USMLE Step 1. Next, we’ll go a little bit deeper into some preparation strategies to help you optimize your studying and maximize your scoring potential.

If you missed part 1, make sure to check it out here.

Tip #5 – Make full use of QBank explanations

Most popular Qbanks offer detailed explanations for each question you might have missed; reading them carefully and adding annotations to the corresponding section of your textbook will allow you to get the most out of the question bank. While the point of question banks is to expose yourself to as many questions as you can, it’s worth slowing down and doing fewer questions per day to really maximize your comprehension of each area you may need to focus on.

Tip #6 – Always, always, random mode

Question banks are incredibly useful tools for putting yourself to the test and exposing yourself to a high question load. Our tutors almost always recommend that when working your way through Qbanks, you should stick to random mode, rather than completing questions by topic or section. This is the most effective way to challenge your memory to recall information, and keep you on your toes, so-to-speak.

Tip #7 – Save the NBME exams for last in order to calibrate your approach

The NBME exams are the closest practice text to the USMLE itself, and are most often used to gauge readiness for the USMLE. There are a handful of online NBME Exams available to take at any given time; however, it can be most effective to save these practice tests for the last month of your preparation. This is because the way the questions are worded are closest to the actual USMLE, which can help to calibrate your test-taking skills and carry you in to the actual exam with momentum. Question banks may have a slightly different style of question than the USMLE, so using NBME practice exams as a buffer before your USMLE test is a good strategy.

One exception to this guideline is using one, or sometimes two, exams earlier on in your preparation to get some sort of benchmark score. While your percentages on question banks and practice exams are only meant to give you an idea of where you stand, sitting an NBME a few months before your USMLE can give you a reference point for your progress, which is helpful to some students.

Tip #8 – Be prepared for diminishing returns

In the early stages of your USMLE preparation, you may find that the material you study in First Aid or another text comes up often in question banks and practice exams. During this stage, your “raw score” might increase relatively quickly. However, as you advance in your study regimen, especially if you’ve gone through First Aid multiple times or completed a number of question banks, you might start to see that “raw score” improvement begin to stall out. This is because in the beginning, you’re covering more common topics that crop up frequently on practice exams and question banks, but as you progress, new knowledge may be more specific and obscure, and may not present itself as often.

Michael Mehlman, MD, PhD, is a co-author of First Aid and has collaborated with Residents Medical for years to develop a comprehensive USMLE study program. In his words, “The amount of time and efforts that it takes for you to go from 190 to 250 is probably equivalent to the amount of time it takes to go from 250 to 265.” Be prepared to feel like your progress might be slowing down as you get closer to your exam date, and keep pushing forward!