As a med school tutor, I often hear:

“I perform well in clinics, but don’t do so great on exams.” 

“I’m just a bad test taker.”

“I’ve never been good at standardized exams—they’re not for me.”

“I get so nervous, I change my choice to the wrong answer.”

And finally, “If I read too fast, I miss an important detail in the question.” 

Does any of this sound like you? If so, don’t worry—you aren’t alone. Mistakes on standardized exams are prevalent among students, especially for high-stakes tests like your board exams. Preparing for medical board exams is a challenging and crucial phase for aspiring healthcare professionals, as these exams determine the level of knowledge, skills, and competence required for licensure and certification. However, the pressure and magnitude of them can lead to mistakes that hinder success. 

Fortunately, bad test performances are often more about poor preparation, than a test-taking issue per se. In this post, we’ll take a look at some pitfalls students encounter when preparing for their board exams, which, if corrected, will result in a much higher score. We’ll also take a look at some genuine test-taking issues as well, and ways to address them.

How a “Bad Test Taker” Can Crush Their Medical Board Exams

To illustrate some pitfalls in preparation that can lead to poor exam performance, let’s imagine a conversation between a Blueprint tutor and a student who thinks they are a “bad test taker,” when in truth, the trouble is in their studying. There are six preparation pitfalls to be found in the following dialogue. Can you find them?

A Conversation with a Tutor

John (Tutor): Hi there! How can I help today?

Micah (Student): I’m feeling a bit overwhelmed with my medical board exam preparation. There’s so much to cover, and I’m afraid of making mistakes that could affect my performance. I feel like I study hard and read through a ton of books, but when it comes to the big day, my performance is underwhelming. Can you help me identify what mistakes to avoid?

John: Of course! I understand that preparing for medical board exams can be challenging. First, insufficient exam preparation is a common pitfall. Have you created a study plan and allocated enough time for each subject?

Micah: I do have a study plan, but I think I may have underestimated the time required for some subjects. I’ll make sure to reassess and allocate more time accordingly.

John: Excellent! It’s crucial to have a realistic study schedule. Another mistake is relying on a single study resource. Have you diversified your study materials and gathered reliable resources?

Micah: I’ve mostly been relying on my textbooks. I haven’t explored other resources extensively. I’ll make it a point to gather more reliable and up-to-date study materials.

John: That’s a great idea! Multiple resources can provide different perspectives and help reinforce your understanding. Remember to focus on your weak areas too. Neglecting them is a common mistake. Have you identified your weaker subjects or topics?

Micah: I’ll make sure to allocate extra time and resources to strengthen those topics. I just hate learning difficult subjects because it takes so long and tough topics don’t stick. I like reinforcing what I already know. 

John: That’s fair but you really should spend more time on what you don’t know! There is much more knowledge to be gleaned in those areas and you can drastically improve your score by focusing on your weaker subjects. Now, practice questions play a crucial role in exam preparation. Are you incorporating enough practice with sample questions?

Micah: Honestly, I haven’t been practicing enough with sample questions or mock exams. I can see how that’s a mistake. I’ll start incorporating regular practice sessions into my study routine.

John: Fantastic! Regular practice with sample questions will improve your test-taking skills and help you familiarize yourself with the exam format. Time management is another crucial aspect. Are you practicing effective time management during your study sessions?

Micah: I haven’t been paying much attention to time management, and I can see how it might affect my performance during the exam. I’ll start allocating specific time limits for each question or section during practice sessions.

John: Great initiative! Effective time management is vital during the exam. Lastly, don’t forget to prioritize your mental and physical well-being. Neglecting self-care can hinder your performance. Are you taking breaks, getting enough rest, and engaging in activities to reduce stress?

Micah: I must admit, I’ve been neglecting my self-care. I’ll make it a priority to take breaks, get enough sleep, and engage in relaxation techniques to reduce stress.

John: That’s wonderful to hear! Remember, a healthy balance is crucial to prevent study burnout. By avoiding those common mistakes and adopting a well-rounded approach to your exam preparation, you’ll be better equipped to excel in your medical board exams. Good luck, and don’t hesitate to reach out if you need any further assistance!

Micah’s Pitfalls in Test Preparation

Were you able to spot the six pitfalls mentioned in this conversation? They are: 1) creating a study plan that doesn’t allocate enough time for each subject, 2) relying on a single resource, 3) neglecting your areas of weakness, 4) not completing enough practice questions, 5) failing to master time management, and 6) ignoring self-care!

If you can get a handle on those exam preparation issues, chances are, many of your exam performance difficulties will vanish into thin air, and you’ll become a much better test taker. 

Of course, testing difficulties are not completely figments of our imaginations, and while many studying issues masquerade as testing problems, there are real exam performance issues that students encounter. Let’s take a look at some I frequently see in my work as a Blueprint tutor.

4 Common Medical Board Exam Mistakes to Avoid

I work with students for various reasons. Often it’s because they have struggled with past exams such as USMLE/COMLEX, or maybe failed prior shelf exams. Sometimes they’re afraid a poor performance on those exams will translate into a failing board score. Or maybe they’re taking practice tests and not scoring so hot. Perhaps their scores indicate they’ll fail the boards, or they’re simply not where they should be compared to their peers. 

If you’re just starting your USMLE exam prep, read this FREE Hero’s Guide to Defeating the USMLE, a 38-page master class from the experts that will save you time and ensure your success when you reach the final boss and face your exam. If you’re further along in your prep, it’s even easier to jump to helpful tips in the guide for your specific stage in the journey!

The first thing I do as a tutor is identify what the real problem is. Is it actually a test-taking issue? As our previous discussion indicated, I work with a lot of students who simply need to put in the time and effort, which is a study issue. However, I also deal with those who struggle with exams but have a decent knowledge of clinical medicine. With those students, what I’ve found is there are patterns that show up again and again. Chances are, if you’re struggling with test taking, you are making some of these common exam mistakes and they’re costing you a lot of points. 

To illustrate why prepared students sometimes still struggle on the board exam, let’s have a look at four common issues test takers encounter. 

1. You didn’t understand the question. 

How you read and interface with board exam questions matters. There’s not a single right way to do so, but I always recommend to my students that they try reading the question stem and answer choices first. This will give you a quick look into what the question is asking and the subject matter.

Start with the prompt, then the answer choices, then read the passage while keeping the prompt and choices in mind. Use clues from the passage to eliminate incorrect answers and narrow down your options. Finally, read each option you haven’t crossed out one by one and compare it to the specific question asked in the prompt. Try this and see how it works. 

2. You have difficulty concentrating during the exam. 

Some students have trouble paying attention during the exam, and this ends up costing them points. In many cases, the fix for this one is pretty simple: practice how you play. For example, you won’t have your phone in the testing center, so don’t scroll through TikTok and Instagram when doing your practice questions. Doing so detracts from your focus and leads to inefficient studying, not to mention creating bad habits. The point is, attention is something you can work on. If you train yourself to focus during study sessions, your brain will be better able to do so when it comes to the actual exam.

Of course, I’m not saying don’t take breaks while you’re studying. If you’ve been at it for hours and your mind starts to stray, take a break. Rest so you can focus again instead of just pushing through. Eat a snack, stretch, take a breather, then come back and be ready to go. To add to this point, take days off. Every week, have a day or two completely away from textbooks or multiple-choice questions. For the average person, I’d recommend 2-4 hours of dedicated study time 4-5 days a week. Remember, you are still in residency while studying for your boards, so free time is hard to come by. 

 3. You just didn’t know the answer.

Of course, sometimes you just won’t know the answer. In my experience, this often happens because the student is prioritizing scores on practice tests over knowledge acquisition. Do you tend to do this? It’s understandable why—you’re a med student, and like me, you probably also enjoy numbers, percentages, and patterns.

However, don’t get carried away with them. I see many students overly concern themselves with how many practice questions they get correct—so much so that they inflate their scores. I’d like to emphasize that question banks are a tool for learning and the score does not matter. I’d rather my student incorrectly answer half of their question bank and learn enough from their mistakes to pass the actual board exam, rather than have them ace the question bank because they answered it “open book style,” and struggle on exam day because of that crutch. 

The focus when studying is not solely to increase your score on practice questions, but rather to gain knowledge of exam content and improve test-taking skills. 

4. You ran out of time and had to guess. 

This has happened to all of us. It’s a shame when it does because if you’d just had more time, you would have answered the question correctly. So it’s an issue with pacing during the test, or “managing the clock,” as they say in sports. 

Once again, the best way to rectify this is to practice like you play. During practice exams, pay close attention to your allotted time and don’t exceed it, or at least make a note of when it happens. Then, if you are going over the allotted time, be sure to have this problem fixed by exam day, so when it counts you aren’t guessing wildly because you’re up against the clock.

Further Reading

So, do you have exam preparation issues, test-taking issues, or maybe a little of both? If so, there’s nothing to get freaked out about. All of it is correctable, and you can still do well on your medical board exams. Remember the six preparation tips we noted in our dialogue and the four common exam issues many students face. Be proactive and get on top of them! If you are still having trouble, feel free to reach out to myself or any other Blueprint board-certified tutors.

If you’re looking for some additional help with preparing for your med school exams, check out these other (free!) Blueprint posts written by expert tutors:

• Help, My USMLE Study Plan Isn’t Working! How to Get Back on Track
• How to Use Active Recall Studying During Medical School
• What’s the Best Med School Study Planner?
• Step 1 Pass Rates Are Decreasing: How to Make Sure You’ll Pass
• How to Prepare for Step 2: The Ultimate Guide