Med School Exams Are Not Going Anywhere

  • Reviewed by: Amy Rontal, MD
  • Ah, the MCAT. You just need to do well on this test before the rest of your life is pure gravy. Even college finals feel like they pale in comparison to the magnitude of this test. You put in the countless hours of studying on top of college coursework to succeed. Or maybe, like me, you get some review books from the library and look at Organic Chemistry for the first time in about 10 years. At that point, it will probably be the biggest test of your life.

    So you do great. You get into medical school. And what comes next? A barrage of tests. There’s mini quizzes, mega quizzes, shelf exams, class finals, unit exams. You do your best, build the knowledge, and what does it all culminate in?

    Another test. USMLE Step 1. Before this test became pass/fail, students would give just about anything, including hundreds of hours, in exchange for a great score. It was here that a top score meant the residency of your dreams, and a failure could slash your dreams of becoming a practicing physician.

    (If you did fail Step 1, check out our article on what to do next.)

    Nowadays, as Step 1 becomes pass/fail, many students have dialed things down to ensure a passing score, but not started to rip their hair out striving for a 260 as we all once did.

    Next comes Step 2 CK. Then Step 2 CS. Then Step 3. Now you are in residency. Add yearly in-training exams onto the list.

    How many tests are we up to?

    After surviving this gauntlet myself, I recently had to take my board certification exams for anesthesiology, which include a 4-hour written multiple choice test, and a much more nerve-wracking oral examination, in which two experienced docs in suits grill you face-to-face on esoterica and handling of emergencies in the OR.

    Tests aren’t going anywhere; there will always be another test. Why rehash the last 97 that I’ve taken, and that you must take before you ultimately achieve your own board certification? There are two calls to action to make sure you are in the right spot for the road ahead.

    Because you will have to take test after test throughout your medical career, it pays to get better at test taking.

    When I say get better at test taking, I don’t mean get smarter and know more answers. The hard work that goes into studying and knowledge building is merely the requisite for achievement. You’ve got to do something more. Whether you are in high school thinking about your future MCAT, or putting together your Step 1 or 2 study schedule, you must devote some of your practice towards test taking in general.

    “How do I practice test taking?” you ask yourself. The obvious answer is by taking lots of PRACTICE TESTS. Just like the concert pianist preparing for the recital, you practice THE PERFORMANCE OF THE ACT ITSELF, not merely the individual parts of it.

    If students asked me for one piece of advice on USMLE exams, if they wanted to know what I’ve learned from teaching hundreds of students this material, distilled into a single piece of advice, I would tell them to do tons of practice questions in a test-simulated environment.

    That means not thumbing through UWorld on their phone while watching a movie. That means at a desk, with feet on the floor, and total focus to the task at hand, just like they will have to on Test Day.

    Some students identify as being “bad test takers.” If that’s you, it is essential that you shake that mentality now. It’s nothing more than an excuse. If that is the situation you are currently in, and that’s how you define yourself, it’s going to be a painful 5-10 years ahead of you that is filled with loads of exams. You’ve identified the problem, but you don’t have to throw in the towel and adopt this limiting belief. Drill down to discover the root of your problem, and find a way to improve it.

    After your next exam will come another and another. That’s why it’s so important to build a strategy for studying and taking tests NOW; one that you can apply and build upon with each subsequent exam. Whether on your own or with a tutor, you have to realize that real success comes from more than just reading a book and doing questions. It necessitates an overarching strategy and approach to the way you look at studying. Do a proper inventory of your approach, and look for ways to optimize both internalization and knowledge (studying) and application of that knowledge in the form of answering multiple choice questions (test-taking).

    Drop the fallacy that you just need to get past this “one last exam” before salvation.

    The promise of future salvation is a defense mechanism we all utilize at sometime, and it does us no favors. At some point, you’ve probably told yourself that you just need to get past one hurdle, get over one exam, and then:

    …I’ll be done with this charade forever.

    …I can get back to focusing on Project X.

    …everything will be peaches and cream.

    …I can stop working hard for a while.

    No matter what you are telling yourself, it’s a mindset that prevents you from ever being satisfied. I’m not suggesting that on the ride home from your Step 2 CS site, that you start studying for Step 3. But find a way to define the situation objectively and with a positive mindset.

    For instance, “Once I get past this test…

    …I will be one small step closer to achieving my life goals.

    …my stress level will decrease, but I will maintain the ambition that I have built.

    …life will be ostensibly the same, and a new test will be on the horizon.

    Find happiness, well-being, and balance now, not after you complete your next test. There will always be another one coming up, and if you will only be at peace “after the next test,” you will never find peace. (But definitely enjoy a cocktail or nice dinner after a milestone test; there’s no evil in rewarding yourself for a job well done).

    There is a silver lining behind the gauntlet of tests ahead: you will be doing this for a while and will get lots of practice. The sooner you realize how important tests and testing strategy are, the better you will perform on all the exams to come.