The Most Important Factor for Board Exam Success

Time. It is the most important variable for Step 1 preparation. It is the great equalizer. Everyone has the exact same amount, but how one spends it will determine his or her board score.

For the most part, people who get into medical school possess the raw intelligence and test taking ability to do well on the USMLE Step exams. I do not want you to read “time” as whoever spends the most cumulative hours in the library scores the highest. Sure, time spent is an important variable but efficiency is equally important. You have to spend the countless hours, but you also have to spend them well.  Although feeling inadequate or not smart enough to score in the top five percent is a common feeling, I am here to tell you that you can. Below are some tips on how to spend the precious resource of time.

shallow focus of clear hourglass
Photo by Jordan Benton on

Make a Study Plan

Make a study plan. After you are a few weeks into your study plan, adjust it as needed. No one make’s an initial flawless study plan because you cannot accurately factor in all of the natural variables. With time, your study schedule will become more refined.  Once you have a battle tested schedule, try to stick to it. Start early and with a light load.  Gradually increase the intensity and efficiency. I started light studying about 4 months prior to my exam date. I focused on one topic as opposed to broadly skimming the entirety of the material. I found this beneficial for multiple reasons. First of all, I relearned some biochemistry that I had for the most part forgotten. Secondly, and more importantly, I learned about what resources I valued and developed a system that helped me learn and retain information.

Establishing good study habits and practices four months away from test date was ideal for me.  Over the next month, I was constantly fine tuning my strategy so that at three months out from test date I had all of the kinks out. I could let the exam be the priority and keep pushing harder and harder until test day.

Some people devote an entire semester for Step 1 prep ignoring normal coursework. Although it may work for some, this is generally not a successful strategy. I know Step is far more important than classroom grades at most schools. While this was also true for my school, keep in mind that all of the material presented in the pre-clinical years is also tested on the Step 1 exam. It would be a shame to learn all previous material flawlessly only to have your score falter after not learning the newest material. I reviewed practice tests with a few students who employed this strategy and their scores were lacking in the areas that they neglected to establish a baseline level of knowledge. My solution to this was to study class work as a priority and then have a dedicated amount of time for Step 1 time at the conclusion of most days or on the weekends. If you learn this new classroom material well, it will not require much or any review prior to the exam.


Once you enter the “dedicated” period of study where Step 1 is the only focus and classroom work has largely concluded, Step 1 is the only thing on your mind. There is not really much to expand on here. Everyone is studying at this point for long hours and working towards the finish line. Finish strong and cover your weak points at the end of dedicated. For me this included a final biochemistry review as well as the statistical sections of First Aid for the USMLE Step 1 just before the test.

Resource Management

Do not get resource overload. Most resources say the same thing in a different format or learning style. Pick three or four resources and utilize these from start to finish, making sure to cover them in their entirety. My choice resources were Sketchy Micro and Pharm (pathology was a budding idea so that was not an option for me), First Aid, Pathoma, and Boards and Beyond. On top of these four resources, I used Anki. Although, I only used Anki to cover material from the four previously listed resources in flash card format. Anki was not for new material.

Well Being

Do not forget about your personal mental and physical health. This is an important part of your time allocation. No one can excel educationally nor perform on an exam if they are mentally and physically spent. I am not saying this road should be leisurely, but remember you do have to be alive and awake to take the exam. Do not think you are immune to burnout. Let’s be honest, no one plans on burning out. It sneaks up on people. It could happen to you. Know yourself and know your strengths and weaknesses. If you can’t study for 100 days in a row, then don’t.

Time is all you need to do well on these exams. Thousands of efficiently spent, intensively focused hours will get you the end result. And lucky for you, everyone has the exact same amount of time, spend it wisely and you will succeed.

Do you have thoughts or questions about the study strategies from above? Leave us a comment!

Back to more resources on board exam preparation.

Leave a Reply

%d bloggers like this: