FAQ

How do you eliminate an answer choice?

Ask yourself, if you were writing the vignyette for the answer choice in doubt, how would you describe it.  If that description is similar to the vignette, then that is likely the answer.  However if the vignette is not like the way you would describe it, then it is likely not the answer.

Should you study from Anki flashcard?

No.  Anki is a component of your overall study plan.  Anki should be used with the goal of retaining information that you have already studied and helping you to organize your review schedule. 

Why do some questions have correct answer options with obscure language?

These questions are purposely written for you to be able to select by omission, similar to some diagnosis that are made by omission.  Sometimes you just have to rule everything else out to get to the right option.  This is a skill only gained through much practice.

How do you review a wrong answer to a question?

When reviewing a wrong answer, determine whether you diagnosed the patient correctly.  If the diagnosis is correct, then it's a knowledge problem and the student just needs to add that knowledge to the concept.  If the diagnosis is not correct then the problem is a conceptual problem and the concept needs to be reviewed.

What are the parts of a question?

1.       Vignette:  The vignette is the story it is comprised of key ideas and connecting ideas.  Key ideas contribute to the answer.  Connecting ideas don’t contribute to the answers.

2.       Question: The question is the challenge. 

3.       The stem of the question is the vignette and the question (it is everything except the answer options).

4.       Answer:  The answer is the correct response to the challenge, which you have to determine. 

a.       Distracters - are options that are clearly wrong and you can see them a mile away.

b.      Pretenders - are options that look right, and you want to choose, but you know better. 

c.       Answer - this is the one you choose.  It’s the best option available. 

What are key ideas in a question?

In clinical questions key ideas are epidemiological information (Age, race, occupation, etc), a patients’ perspective and a doctors’ perspective.   In non-clinical questions the key ideas are determined by the question itself.  The question will tell you what data within the vignette you need to be looking for in order to select the correct option.

What are 1-step, 2-step and 3-step questions?

1-step questions are relatively easy questions where the vignette describes a concept then asks the student to identify that concept.

In 2-step question vignettes describe a concept which you are expected to identify.  The question being posed assumes that you know the concept, and proceeds to ask the question on this assumed knowledge.

In 3-step question vignettes describe a concept from which you are expected to deduce a second associated concept, then they ask you a question about a third associated concept.  

What are sequential questions?

These are 2 or 3-step questions which have actually been written out as two questions.  They give you one questions with the answer options.  Then they give you a second question based on previous question.  They do not allow you to go back and change your previous answer. 

Should you attempt questions even if you don’t know the subject?

Yes.  Attempting to answer questions on material results in better retention even if the questions are answered incorrectly.  This is because you will either review old information or learn new information that you can reinforce or connect with other concepts.  You cannot lose by attempting questions.  

What if none of the answer options seem correct?

Attempt to figure out what questions are wrong.  Don’t try to make the answer right, idenfify why its wrong.  The right answer must completely agree with the stem.  If there is ONE thing where the answer does not correlate with the stem, it is a wrong answer and can be eliminated. 

What if I have it narrowed the options to two possible correct answers?

The first time pick the best option that is closest to A.  The next time pick the option closest the last answer.  This will not increase your score but it does save you time that you can use on other questions.  

Should you do question with a partner?

Yes.  Make sure your partner is using the same technique as you are in answering questions.  Your partner will be able to point out inconsistencies in your process that you yourself won’t be able to identify. 

Should you do timed or untimed or tutor questions?

If you are early in your study, you need to practice and master the technique so you should do untimed tutor questions.  Once you feel confident in your technique you should start doing more timed questions.  If you are thirty days away from your test date you should be doing timed test.

How do you select which questions to attempt?

Attempt questions relevant to the subject your are currently studying.  Periodically do a mixed set.  If you have already studied everything then study your weakest subject. 

Should you read the answer choices before reading anything else?

No.  read the question first then the vignette, then answer the question.  Good test takers spend most of their time in the stem of the question (75%)not the answer options (25%).   

What is indicated when you answer the question wrong?

There is either a lack of knowledge or poor mastery of a concept.  If you knew the diagnosis but did not know the answer it’s a knowledge problem.  Knowledge problems are easy to solve, just add the knowledge to your fundamental mastery of the concept.   If you did not get the diagnosis then it’s a concept problem and you need to go back and master the concept.  Mastering concepts take longer and last longer.  The longer you take to master a concept, the longer that concept will remain in your long-term memory. 

What is indicated when the wrong answer you picked is the most popular or next most popular answer?

It means that you got the question wrong and you need to determine why.  You do not want to be on that side of the equation.  If you are progressing because you picked the most popular answer, then when you pick the least popular answer you are regressing.  The focus should be on forming good habits by applying correct technique.  Knowledge problems are easy to fix, habits are much harder to fix.

 

How many questions are on the test?

322 questions, 7 blocks, (46questions each)

What are the best resources to prepare for step one?

It’s a hard question to answer because learning differs from person to person.  The advice here is the fewer the resources you use the better.  You should have at least one reference book.  And one book to use for notetaking.  And First Aid. 

How do you know if you are ready to take the exam?

MBNE will tell you.  It’s the most widely accepted objective metric.

What to do the day before the Exam?

Do not study.  If you study the day before the exam the information you study will be in your working memory, making it difficult for you to retrieve other information in your long term memory.  Trust in your process and take the day off.

Get rest.  You want to rest well so that your body is relieved and stress free.  

What to do the day of the exam?

Have a healthy breakfast.  Foods with carbohydrates and meats increase blood levels of tryptophan.  This leads to increased uptake of tryptophan into the CNS.  In the brain, tryptophan increases sleep-promoting melatonin in the brain.  Further, it takes a lot of energy to digest food.  This combination can lead to fatigue during the exam.

Dress comfortably. 

Arrive early at the Prometric testing center.

 What determines whether you will pass USMLE?

Ability x Effort = Result.  Your ability has to do with your proficiency in medical science testing.  Medical science testing ability includes knowledge and testing talent.   Effort is the energy you exert in this process.  If you have decreased ability then you need to place a lot of effort.  If you have increased ability then you can place little effort.  You can determine your ability by taking a standardized test.  

What factors impact your score?

Knowledge, test taking skills and attitude.  In that order.

What are the biggest mistakes made on exams?

1.       Passive studying

2.       Insufficient practice test

3.       Memorizing not understanding

4.       Inappropriate test day strategy

5.       Misreading questions.