How to Guess on USMLE Step 1

Facts: You will not know the answer to every question on USMLE Step 1.  Successful students have a strategy on how to approach questions to which you do not have answer.  The guessing strategy for questions to which you do not know the answer can play an important factor in your overall success on USMLE Step 1.   Students with a strategy perform better than students who do not have a strategy.  

The first step in this strategy is eliminating wrong answers applying the 100% principle.  The 100% principle states that the correct answer must agree 100% with the question and vignette.  It’s worth re-typing.   Read carefully.   The correct answer must agree 100% with the question and vignette.  Not 99%, not 85%...It must agree one-hundred percent.  If there is an option that does not coincide with the question AND vignette you WILL eliminate that option.  It will be discarded to the deep dungeons of hell.  And it will never return.    There are no if, ands or buts.  

Once you have eliminated those options you may still have doubt of the other options that cannot be definitively eliminated. In step-one you either know the answer or you don’t. If you do not know the answer based on the options that are left, you will guess.  Guessing does not mean you are giving up on the question.  Guessing on USMLE Step 1 means you are applying a different strategy to a particular question, which will in turn increase your chances of being successful with the step-one exam. 

Think of it like this, you are at war and each question is a battle.  The battles are important but not as important as the war.  In this particular battle, you don’t know the answer.  You know you don’t know the answer.  Don’t waste time thinking that you are going to figure it out.    The test is not structured to give you the time to figure things out. The test IS assessing how well you manage time.  This means that you must have a time management strategy for questions for which you don’t know the answer.   This can also be called a time management strategy for guessing.

To understand why a strategy for guessing is important, think of this.  The odds of you getting 'guessing' question correct are never going to change.  For example, let’s say you narrow your options to A, C and D.  Your chances of getting this question correct is one out three.  Irrespective of what strategy you implement those odds are not going to change.  If you have a strategy for dealing with questions, you can then apply the strategy and move forward.  

A sample strategy may look like this.  Lets assume that your options are A, C and D.  You can decide to always pick A in these situations.  Recall that odds are still one out of three so its not very important what strategy you implement.  Alternatively you can always pick D (odds don't change, its still one out of three).  Or you can rotate your picks.  First time A, second time C and so forth.  

Remember that ultimately what strategy you select is not as important as having a strategy.  Having a strategy will save you a considerable amount of time, which you may need to read very long vignettes.