Scheduling Step 1 After a Med School Leave of Absence

  • /Reviewed by: Amy Rontal, MD
  • Everyone has their own path through medical school, and for many, that includes taking time off for reasons that may be personal, professional, or both. It’s important upfront to acknowledge that this is perfectly acceptable. Medical education and training is long and challenging, and life outside of medicine for many people may require that you take a break from your studying and learning. If this break happens to occur shortly before or during your study period for Step 1, it can be challenging to determine how to go about diving back not only into medical school but also your preparation for Step 1. This post will help you navigate the considerations that go into this.

    How to Schedule USMLE Step 1 After a Leave of Absence:

    1. Reintegrating back into the curriculum

    The first step that you should take when scheduling Step 1 after time away from med school is working with the administration at your school to re-assimilate yourself back into the curriculum. This will allow you to develop an estimated timeline of when you would need to take the board exams, complete rotations, and apply to residency, thus allowing you to make a plan going forward.

    Furthermore, diving back into preclinical coursework will allow you to continue building the fund of knowledge that you had already started to compile. In other words, you should jump back in where you left off. You should not feel compelled to start over, as this would be unnecessary and set you too far back. You will have time in your dedicated study period to review previous concepts, but as you move forward in the curriculum, you should focus primarily on keeping up.

    2. Allow extra preparation time for Step 1 after time away but do schedule your exam day!

    It may seem intimidating to open First Aid or start doing UWorld for the first time after a leave from medical school. You might feel overwhelmed because so much of the material looks unfamiliar. It may even be tempting to assume that the reason it seems so challenging or different is because of the time between when you first learned some of this information and when you are now reviewing it. It’s important to realize that trying to accumulate the amount of knowledge that is tested on Step 1 is challenging for everyone, no matter how near or far removed you may be from when you were first exposed to it.

    It is worthwhile to allow additional time to prepare for the exam, given that you may benefit from more review of certain concepts you have not seen in some time. The amount of time you need is a highly personalized consideration that requires introspection about where you are and evaluation of where you want to be and what your goals are; speaking with faculty, mentors, or a tutor can be very helpful in this process.

    Once you have a sense of your timeline and how long you intend to make your dedicated study period, you should proceed to obtain your permit and schedule your exam. Even if you do not feel confident in the test date you select, it is better to keep something on the calendar and have an endpoint in site. This will also keep a seat reserved, as far too often test-takers wait to schedule their exam and then find that all upcoming dates at their preferred testing center have been booked.

    3. How to approach your Step 1 dedicated study period after a leave of absence

    Regardless of whether you are just finishing your preclinical curriculum or it has been some time since you have been exposed to the basic sciences, you should begin your dedicated study period with a plan of what and how you will study.

    Specifically, you should explore the resources that are available to you and identify the ones most compatible with your style of learning. In addition, as you develop your timeline, you should think about the order in which you will move through the material and triage areas of opportunity first. In other words, if you covered biochemistry and microbiology before your leave of absence and are now far removed from that content, it would be worthwhile to start with these blocks.

    It needs to be reiterated that as you move through the material, you should not lose sight of the fact that Step 1 is challenging for everyone regardless of whether they had taken a leave of absence. The important thing is to be efficient and dedicated. You may be very surprised to find that material you felt you had forgotten comes back very readily to you.


    The bottom line

    You should not fear Step 1, even if it has been a while since you reviewed some of the concepts it tests. Instead, you should focus on diving back into your medical school curriculum and keep up with the content as best you can and then adjust the length of your dedicated study period and how you use that time to compensate. You should also not lose sight of the fact that Step 1 is challenging for everyone and not uniquely difficult for you alone, and with the right amount of dedication, you will be able to achieve your goals.