USMLE   EXAMS

The Right Way To Prepare for the USMLE Examination

Featured Article Chicago January 27 J Kruger

USMLE to this day ranks as one of the most difficult exams to perform well in. If you noticed, I did not use the term 'pass' because a pass in USMLE means absolutely nothing. In fact it is better to flunk your USMLE rather than manage a creeping crawling panting miserable bare pass. USMLE is one of those things in life where either you are at the top or you are nowhere.

The number of quality training positions have declined in the last several years due to a variety of factors, and at the same time competition for these positions has become extraordinarily competitive. And remember, you are competing with talent all over the world, you are competing with the best graduates from hundreds of medical schools all over North America and the whole world.

The study material that is required for preparing properly for USMLE has also exponentially multiplied. There is traditional preparatory books like the time honored NMS series , which we strongly recommend, as also several newer books which promise quick , easy and effortless results. You are old enough to know that nothing worthwhile in life comes quick, easy and effortless. The USMLE is one of those things that is well worth dedicating an entire year of preparation to. Because the purpose of the entire exercise is to be at the very top of the USMLE totem pole.

The outcome of the USMLE will determine whether you get the speciality of your choice. If you are a foreign medical graduate your score will decide if you will get any position at all, since in all probablity you dont have any 'connections' in any of the training facilities.

The cost of preparing for the USMLE is another big factor. The average medical student is already hounded by creditors over the loan money he owes, and it is not easy to add more expenses on top of a debt that will take a third of his working life to get out of, and he may never ever get out of debt when you factor in all the other new obligations that jump in upon graduation.

If you are from a third world country where medical education is relatively cheaper, still the USMLE could pose a big financial burden when you factor in the expensiveness of the application process, the fees involved for each time you attempt the exams, and the expenses connected with travel and immigration.

So what is the best way to streamline your USMLE preparation? There are several ways in which you can make your preparation pay off. But none of these methods is easy.

The first step is to decide whether you are going to attempt both parts at the same time or separately. Most sane individuals attempt one part at a time, but there are brave souls who do attempt both parts at the same time and pass with flying colours. I would strongly advise to attempt one part at a time, your scores will be much higher, and trust me, there is no medals for bravery in USMLE, either you are at the top or you are dead in the water.

The next step is to pick the books you want to use. The rule is to stick to standard textbooks, avoid the temptation to use some 'short-cut' textbooks. We have listed on this website a few books that we recommend, but talk with your buddies who have already aced the USMLE and get their advise as well before you make your list of books. Once you decide on your booklist, stick to it.

The third step is to get a few reams of writing paper. Yes you heard it right, a few reams of paper, you will need something like a couple of thousand pages or so. This is for writing notes from the textbooks you are reading.

When you are reading, ask yourself after every sentence, what kind of exam question could potentially be framed from this sentence. And once you understand this strategy, you have mastered the USMLE. When preparing notes, don't make a laundry list of points to remember, because there is no way on earth you are going to remember all those points when you are sitting there in the exam hall sweat pouring down your brow.Write the points in question format. For example, instead of writing, 'Single fiber EMG is the most sensitive test for Myasthenia Gravis', write your note in this format: 'What is the most sensitive test for Myasthenia Gravis?'

You can write the answer on the other side of the page if you want. Now before you scoff at this strategy, take a deep breath, sit down and listen to what I have to say. Have you ever noticed the format of webpages that are trying to sell you something? They always start with a question. And why is that? Because the human brain is designed in such a way that when a question pops up, the brain automatically searches for an answer, which may or may not exist, and may or may not be correct. In other words, the act of presenting your brain with a question turns some mysterious switch on, whereby your brain goes into 'WRITE INTO MEMORY' mode, it becomes receptive to whatever comes next. And whatever you present next to your brain sticks! It is as simple as that.

Whatever you do, do not use Multiple Choice Questions to prepare for the USMLE. Yes, the USMLE is in multiple choice question format. But the preparation should never be done in the same format. Because multiple choice questions are built for testing, they are not built for teaching or learning. When the brain is presented with a question and several possible answers, the brain goes into 'I AM PUZZLED' mode, and you are not going to remember a thing. It is like when your car is in neutral gear (if you remember old style stick shift cars), it does not matter how much you slam your foot down on the accelerator, nothing is going to happen.

There are books and software available where the the entire subject is presented in a question and answer format, enabling fast memorizing of all the points that are likely to show up in the exams. But the best (and cheapest) way to do this is to make your own questions and answers. Especially if you are from a country where you cannot afford to buy any of these snazzy software , you should write your own questions and answers.

Yes it takes time, but then everything worthwhile in life takes time. When you make these notes, you absolutely need to make a time schedule that you should stick to. If you decide that you are going to finish the first two chapters of Guyton this evening, do it no matter what, even if you have to drink a gallon of coffee to stay awake and you have to turn down your gorgeous girlfriend's overtures (despite her flaunting the latest from Victoria's Secrets). Don't sleep till you finish your target for the day.

Yes it is not easy, but then you are the one who set out to be a doctor; no one told you that it was easy. You also need to set aside time to test yourself. If you use six days out of the week for preparing notes, use the seventh day for testing yourself. Open those notes you made (a-ha, now we will see who has a legible handwriting!) Read the questions you made, and see if you can remember the answers. If you don't, it is ok, just turn the page and look at the answer. You can bet your buttons that you will remember it on exam day, which is what matters.

I have had friends ask me, should I use handwritten notes or computer typed notes? By all means use handwritten notes. I dont know why it works better, but just take my word for it- handwritten notes always win!

Any more advise on exam preparation? Well the last item on your strategic plan should be to highlight those questions in your notes that have answered wrong during practise sessions. Read those again a week before the exam. Trust me, that goes a long way in making your scores go through the roof.

Suggested Study Materials:

USMLE Total Review Software

Kaplan Review Series

Please contact us with any new outstanding study materials, so that we may include it here. We define outstanding as something that can increase your chances of significantly improving your USMLE scores.

And in the meanwhile, goodluck with your exam prep.

Edited by Johanna Kruger