HealthJanuary 30, 2020

How to prepare for the USMLE: Where should you begin?

By: Brian Wu, MD, PhD

If you’re preparing for the USMLE or COMLEX, you’re probably feeling more than a little stressed about where to begin. While it’s only natural to be overwhelmed, there is good news: You have a wide array of resources at your fingertips, and a well-thought-out game plan will help reduce your test-related anxiety.

Here’s a look at how to prepare for the USMLE or COMLEX. These are far from the only steps you’ll need to take over the next several months, but they’ll help you feel grounded and ready to dive in.

Get the basics down

Start by getting familiar with the Bulletin of Information (or BOI) for the exam you’ll be taking. This is required reading: The BOI contains important information about eligibility requirements, exam descriptions, scheduling, scoring and transcripts. If your eligibility period for the USMLE Step 1 extends into the next calendar year, you’ll need to read the BOI for that year as well as the current year.

You can find the Bulletin of Information for the USMLE and the COMLEX on their respective websites.


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Set realistic goals

One of the most important things you can do at the outset of your USMLE journey is to establish a realistic goal for how you want to do on the test. To know what a realistic score is for you, take a practice test and then set a score range that’s ambitious but still achievable. The score does matter: A low score on the Step 1 can have a sigificant impact on your career because it can make it more difficult to be matched with a residency, especially if the specialty area you’re considering is competitive.

The USMLE website offers practice materials for Step 1, including PDF sample test items, web-based tutorials and practice tests. To gauge your readiness to take USMLE Step 1, you can also invest in a comprehensive self-assessment or a timed practice exam that’s administered by the National Board of Medical Examiners (NBME). Like the USMLE itself, practice exams are administered at Prometric Centers.

The National Board of Osteopathic Medical Examiners (NBOME) offers practice exams for the COMLEX Level 1, too. Consider purchasing the Comprehensive Medical Self-Assessment Examination (COMSAE), a three-phase exam that tests knowledge and ability. COMSAE study materials and practice exams are also available on the NBOME site.

Give yourself enough time

When you applied for the USMLE, you chose a three-month eligibility period in which you will be able take the test. (You can choose an eligibility period up to six months ahead of time.) For the COMLEX Level 1, you can choose an exam date up to six months in advance.

It’s crucial to start preparing early. Since the USMLE and COMLEX require thorough studying, this will help you feel less stressed and better prepared when it comes to taking the test itself. Also keep in mind that if you put off studying and aren’t able to test within this period of eligibility, you’ll have to submit a new application and fee.

Study smart

With the massive amount of material to cover for these exams, it’s no wonder if you feel overwhelmed, especially at the beginning. However, your practice exam will give you a sense of your strengths and weaknesses, and then you can think about how you learn best and come up with an effective study strategy.

For example, if you know you’re a strong visual learner, use graphic organizers and other visual tools to help you get a handle on the material. If you learn better from discussion and interactions, consider joining a study group with other medical students who are also preparing for the exam.

While it might seem obvious, it bears repeating: Honing your most basic study skills, such as taking accurate notes and reviewing answers and their explanations thoroughly, are key ways to strengthen your position for when you take the test. However, these activities take time, so again, make sure you’re giving yourself enough.

Know what resources to use

There are plenty of resources to help you learn how to prepare for the USMLE. Online question banks are a popular study tool, and for good reason. Some, like Firecracker, are even personalized to your specific needs so that you’ll feel in control when your exam day finally comes.

In addition to flashcards, you’ll also want to choose a supplementary text to study. These books walk you through the kinds of questions you’ll see on the exam as well as their answers. Also don’t forget that you can find many resources to help you study on the USMLE, NBME and NBOME sites.

Even if you know when you plan to take your exam, you might be worried about how to get there from here. Don’t panic. Instead, focus on what you can do today to set yourself up for tomorrow.

Brian Wu, MD, PhD