How to save time on USMLE Test Day ?

How to Save Time on USMLE Test Day ?


As we all know the USMLE Exams are very lengthy and hence time management is crucial both during the exam blocks as well as during the breaks. USMLE Step 1 Exam is 8 hours long and is divided into 7 blocks of 40 questions per block and a total of 280 questions overall. The USMLE Step 2 CK Exam is also similarly lengthy, being 9 hours in length with every block having 40 questions and a total of 318 questions spread across 8 blocks of 60 minutes each.

Each USMLE Step has a break time of 45 minutes. Most students find the USMLE Blocks significantly lengthy and finish the blocks in just the nick of time. So utilizing the time during the blocks optimally is very important. The break time is also limited and we have to use the rest room, eat and refresh ourselves so as to tackle the next block. Optimally utilizing that time is also very crucial.

According to my observation, Test Day performance is the most important variable in deciding the actual USMLE score.

Giving the test well by preparing before hand could mean the difference between a 230 or a 260. So i advise you to plan well in advance to get the highest possible score.

I used the following methods to make sure that not only do i finish the blocks on time but also have sufficient break time to relax and recoup before the next block. I recommend you read this in it’s entirety as i believe it helped me improve my score by atleast a few points. The suggestions are easy to follow but many of them are creative and not practiced widely. So it is worth having a look.

#1 Skipping the Tutorial

The USMLE steps have a tutorial at the beginning which explains how the test is structured. It gives information about the interface, the buttons in it, the layout, how the timer works, etc. All of this information is already given in the free practice materials that are provided in the FRED simulation on the official USMLE site. Skipping the tutorial would mean that the 15 minutes allocated to it would automatically be allocated to the break time. That increases the break time from 45 minutes to 60 minutes. I recommend you skim over the simulation a day before the exam so that you are aware about how the interface and the exam is structured. This would mean that you dont waste time in going over it before the exam. This is a commonly used method for time saving in the USMLE break time.

#2 Start every question by quickly reading the last sentence and scanning the answer choices

Usually the most important part of the question is the last sentence. The USMLE questions have a habit of misdirecting us in the wrong way and then revealing the most important part in the end. For example: there could be an entire question describing cystic fibrosis, like: Child had meconium ileus, mother says that the child tastes salty on kissing it, it has positive chloride sweat test, etc.. they would explain the entire disease in detail giving lab findings and everything. While you are reading all this your mind may be going through a 100 different things related to Cystic Fibrosis. However, the question could be something like: If this couple has another child then what is the possibility that it too shall have the disease ? So while you are reading a lengthy question stem you are actually wasting time thinking about the signs and symptoms, diagnostic findings, treatment guidelines, etc of cystic fibrosis and wasting time.

Now imagine how easy the question would have been had you read the last line of the question i.e. the actual question stem before reading the earlier part “If this couple has another child then what is the possibility that it too shall have the disease ?” . If you would have read this first then you would already have known that the question was related to genetics. Then the only thing left to do would be to diagnose the disease and then think about ONLY the genetic component. This would save an incredible amount of your time (which is already scarce in the USMLE test). Hence, I would recommend that the FIRST thing to read in a question is the LAST thing written in a question. This will be a big time saver while doing the USMLE blocks.

#3 Memorize Lab Values

As is already known the USMLE Exam is pretty lengthy. While the USMLE provides lab values in the interface, it is a good idea to memorize the list provided in the USMLE website. Following is the list of lab values you should remember. While it is always possible to lookup a value in case you dont remember it, it is much better to not waste time doing so in the exam. Memorizing lab values will save an incredible amount of time. In many questions there will be almost a page full of lab values and it would become practically impossible to go into the lab values part of the interface to check out each of them.

This point alone is the greatest time saver while doing the USMLE blocks

#4 Only mark questions that more time will help with

The “mark” function in the USMLE interface is the most inappropriately used function in the world. The purpose of the function is to MARK a question so that you can come back to it later. However, when faced by a tough exam with many WTF questions, many people mark tons of questions and eventually dont have time to come back to them or see them again. This is an incorrect way of using the MARK function. It should not be used indiscriminately. For example if there is a question which you have never heard about and they are asking you the chromosome number of the disease, then there is no way you can make a better calculated decision than the one you would make the first time. So I think the right way to use the USMLE “MARK” function should only be to mark questions where there is a reasonable chance that if you are given more time then you would be able to make a better decision. Marking 15 questions in a block and then not having time to review any of them is not a smart idea. Mark wisely !

For example if they ask you the function of the gene causing Aarskog syndrome and you have never heard of it before then a smart decision would be to just make a calculated guess and move forward instead of marking it.

If however, on the other hand if there is a question about something common like ACE inhibitors then it would be smarter to MARK the question if you cannot figure it out for sure on the first try and think that reading it again would be helpful.

This tip will help save time during the USMLE blocks solving process.

#5 Take break on the table itself

A common issue faced during the exam are the repeated security checks, pat downs, signatures and finger prints that you must take each and every time you go out and come back in. The process of checking in and checking out in between blocks during the break time, in and of itself is very time wasting and anxiety provoking. A smarter way to take a break if you dont need to go to the washroom, dont need to eat or drink and just want to take a couple minutes off between the blocks is to take the block at the computer table itself. After a block ends you could just take a break and sit at the table itself instead of going out to the lounge area and back. This is because merely going out and coming back in would likely take 4-5 minutes every time. It is a much better use of time to just click on take a break after a block ends and even closing your eyes for a couple of seconds or just resting while sitting at the table might help freshen you up in the exam break time. This is a simple way to save a couple of minutes during the break time.

#6 Pocketless Tshirt & Pants

As mentioned previously the check in and check out process is quite tedious and time consuming. An easy way to save a few minutes during the break time is to get a pair of pocketless Tshirt and Pants. The reason is that they make you invert your pockets everytime you check in and check out. This time can be saved by merely not having any pockets ! 😀

Make sure you follow these suggestions. These have been created after reading hundreds of experiences and represent the collective wisdom of many doctors who have aced the USMLE in the past. While everywhere else Time = Money, in the USMLE, Time = Marks !!

October 28, 2017
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