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Virtually every medical student who has prepared for Step 1, Step 2 CK, or Step 3 has used UWorld (sometimes called “UW”). Formerly known as “USMLE World”, it is held in near-religious reverence for its questions that match the USMLE Step exams’ two-step reasoning process, with explanations that bring medical students to tears of joy and have cured several forms of cancer. I jest, but when I was a preclinical medical student at Stanford nervously anticipating my USMLE Step 1, I bought everything I was told.
“Everyone” knew that all you had to do to destroy Step 1 was to read five times, and do UWorld at least twice (and review your wrong answers another couple times for good measure). Then and only then were you ready to brave the rite-of-passage exam. So why did I ignore this advice?
And what did I do to eventually boost my score to 270? Here I deconstruct several of the most common beliefs surrounding the UWorld Question Bank, and see whether they withstand rational scrutiny.
Know that as much as the “common knowledge” surrounding UWorld is opinion, this is also my opinion, based on my experiences preparing for Step 1/Step 2 CK, as well as having tutored students for the USMLE Step and Shelf exams. NOTE: I considered sifting through any of the number of anonymous USMLE forums to find examples of this advice, but to be honest, I still get pangs of anxiety whenever I look through those forums, with all of their distress and breathless dogma. If you are one of the admirable, brave souls who can use those without getting palpitations and find any such advice, share it in the comments and I will update this article (but I might not visit it myself =). Claim #1: You must repeat UWorld at least twice (even if it means not doing another QBank) This is perhaps the most common advice I heard as a medical student, and one that I ignored. What is the basis for this common medical student belief?
The main reason given is that, because UWorld is such a fantastic resource (and it really is), that doing it MORE THAN ONCE will somehow boost your score even further. This is one of the most common misconceptions I see among students preparing for Step 1: if something has helped you in the past, then somehow doing it infinitely more will increase your score indefinitely. This sounds reasonable until you consider that it ignores the opportunity cost of spending weeks repeating UWorld over and over.
In other words, every single time you repeat a UWorld question, you are losing the opportunity to study a question from a different question bank, one that might help you grow your knowledge in other ways that UWorld will not. UWorld is fantastic, but is by no means infallible. There are definite strengths and weaknesses to UWorld, and to ignore other valuable resources is to set yourself up for potential disappointment. For example, it is excellent at making difficult two-step reasoning questions, although tends to be weaker on more recall-type questions that are also seen on USMLE Step 1. Verdict: Fiction, although to get the most out of any question bank, make sure to to make sure you never make the same mistake again. “So how many times would you recommend repeating UWorld?” UWorld questions are as close to the real thing as possible.
As such, I did NOT do UWorld twice. I considered, and still consider, UWorld questions to be as close to the real thing as possible, and as such, I do NOT recommend doing UWorld twice.
One of the most difficult things about the USMLE Step 1 is that you will see questions that you have never seen before, or even thought about. My real secret to scoring 270 on Step 1 is this: knowing how to reason through questions that you’ve never seen before and arrive at the right answer differentiates people who are scoring. Concluding thoughts While I am sure there is going to be disagreement, my goal with this blog post was to challenge the dogma surrounding the use of UWorld. While it is no doubt an extremely useful question bank, it is by no means the holy grail of USMLE Step 1 preparation as it is so often held to be. Ultimately, your preparations and how you use these resources will depend on what you believe the test to be about, and what you believe it takes to get a high score. As a medical student and USMLE tutor, I worked under the assumption that Step 1 wouldn’t be a receptacle for me to regurgitate UWorld/ knowledge, but rather a series of carefully constructed questions that would test my ability to integrate and apply pathophysiologic principles. You are free to disagree (and I welcome your thoughts in the comments)!
Remember that there isn’t only one way to approach using UWorld, and that there are plenty of viable, rational alternatives! What to do next?. Curious to know how I prepared for the exam?
Check out the. Worried this is only a single voice in the wild? Check out these. Planning on doing more than one QBank?
Check out this article. Interested in? Check out the Want to Save Time and Boost Your Score?
Do you lie awake at night, sweating the thought, “I should be studying right now?” Are you constantly running from activity to activity, feeling like your life is no longer your own? Do you watch lectures and wonder, “why can’t someone just TEACH me something?”, including high-yield facts along with a growing list of explanations for some of the most difficult-to-understand Step 1 concepts. What do you think? Are you still planning to repeat UWorld twice?
Other thoughts? Let us know in the comments!
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