Medical student resources

Using USMLE question banks effectively

Over the last 10 years online question banks have become the most used USMLE test prep tool. While UWorld Qbank dominates the market, there are several high-quality question sets with good user interfaces. Regardless of the product you choose, there are some “best practices” to improve your prep time.

Choosing the right question bank.

Medical students often use a “primary” and a “secondary” question bank. The primary is used a the initial study tool, and provide detailed answers that teach you the material basically from scratch. Two Qbanks stand out here: USMLEWorld and Kaplan Qbank. These are well curated question sets with long answers that have been honed over a decade or more of user experience. They’re great for your first-pass learning.

The secondary question banks are for review and filling in gaps. Answers are informative, but do not teach the material from scratch. You can use these as quick reviews on the bus, during “casual study” time, or in study groups. The high qualty secondary Qbanks include USMLE Rx.

When to take diagnositic exams?

Diagnostic exams are very useful in gaging how well prepared you are at different stages. If you going to take USMLE Step 1 at the end of your second year, don’t start your prep time with a diagnostic. Your grades and class rank tell you how well prepared you are going in, and you know what weak subjects are. If you are a non-traditional USMLE taker (an IMG, completed medical school a few years earlier, transferred between medical schools in the first two years, etc.) it could be helpful to take a diagnostic test early on. Use the information from the diagnostic test to help set up a study schedule.

The NMBE has diagnostic tests for a fee. Kaplan also has a USMLEdiagnostic test that is free (the only cost is that you get on their USMLE marketing email list). You might start with the Kaplan test, and save the NBMEs for later in the process.

If you divide your study block into thirds, plan to take a diagnostic test at the end of the first and second thirds. If you don’t have significant score improvement on these diagnostics, you might consider reassessing your study plan. This would be the right time to decide if you need to delay your step.

While you can retake a step, failing a step is a big hurdle to overcome in getting a residency. Use the diagnostic exams to help guide you to a first-time pass. It’s better to delay and pass than to take the test on time and fail it.

How many questions to do at a time?

Early on in your studying (the first third of your study block) the emphasis should be on learning. Take a few questions at a time in timed mode. Typically I recommend doing blocks of six questions. Taking it timed mode gives a slight sense of pressure, and the associated mild stress response will help you retain information. Limiting yourself to 6 questions means you will still remember your internal rationale in chooing an answer when you are reading the answers.

And the key in this period is to read the answers thoroughly - read all the answers, whether you got the question right or wrong, and read all parts of the answer, even if you think it is obvious. The primary Qbanks have been written such that improtant learning points are put into every part of the answer block.

The other benefit of doing only six at a time is that you can always make it through the answers for the block you just completed. It might take you 10 minutes to answer 6 questions, but it should take about 20-30 minutes to read and understand all the answers. If you try to do blocks of 40 questions a time it is really unlikely you will get everything you need to out of the answers. I’ve been there - at about question 30 you can’t stand it anymore and either skim through the answers or just close up to come back to it later. Your losing a quarter of your learning opportunity that way.

Starting in the 2nd third of your studying you can move on to longer blocks. This is often a good time to start using the secondary Qbank - the answers are shorter so the “post-test” period isn’t as arduous. Start by doing 20-question blocks a couple of times a week. Then, in the two weeks before your USMLE is scheduled start doing full 45-question blocks under timed mode. Here you are practicing test taking - making quick decisions based on the key information in the question stem.

How many times to go through the same question bank?

I’ve heard many students say they went through the same question bank twice. I don’t agree with this approach. If you did it right the first time (see above), you will have gotten the most out of your time with the question bank. If you have time to do more questions (and its great if you plan it that way), then get a second question bank.

Each question bank presents topics in slightly different ways - both in the question stem and the answer - so doing two qbanks will get you more and different exposure to the important topics.

Any of the question banks mentioned above would make a good second qbank resource.

How to know when you’re ready?

Students often get frustrated when the start with a q-bank. Scores on UWorld questions are often in the 30s or 40s, far from your goal. I don’t know if UWorld presents questions this way on purpose, so you feel you are making good progress as your scores improve, or in fact you are making good progress. Regardless, this is a common pattern and you should feel discourged because you scored a 38% over the first 200 UWorld questions you answered.

That said, over time your score should improve dramatically. The typical progression is scoring around 60% by question 1,000 and in then 70s around question 1,500. If your overall score is in the 70s, you are probably in good shape for passing the test (no guarantees!). If after question 1,000 you are still in the 40s or 50s, consider taking a diagnostic and making changes to your study plan. At this point a USMLE tutor might be beneficial.

How competitive am I for residency?

Will you be AOA?:Yes
No
Have you done research?:Yes
No
Do you have publications?:Yes
No
Are you a US senior in med school?:Yes
No