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Should I Move My USMLE Test Date Up?

How many of you clicked on this post just because you thought this sounded like a crazy idea?  A test as important as the USMLE — and here comes someone talking about taking it sooner than you had scheduled it? He must be insane.

Yet, while this is nowhere near as common of a dilemma as pushing your test date back, I have worked with many students who have encountered this conundrum. Moreover, I can confidently say that in certain situations, moving your test date up can lead to a higher score on the USMLE. So how do you know if this is the right decision for you?

Before we can have this discussion, let’s establish some baseline performance milestones that need to have been met before you even consider moving your test date up. The most important of these criteria are:

  • An NBME score at least 10 points above the passing score requirement (and preferably, at least two exams above this score)
  • Completion of UWorld at least once
  • Completion of First Aid (if taking Step 1)
  • Sufficient time to adjust your study schedule to make the most out of your final days

Next, you need to have a good reason as to why you are contemplating moving your exam date up. Unfortunately, things like a last minute vacation, desire to binge-watch Game of Thrones, or plans to attend the NBA Finals don’t exactly count as good reasons. However, here’s some that are:

  1. Scores significantly above a 250 on the NBME
  2. Significant study burnout and fatigue
  3. Evidence of peaking (or worse – declining) on your NBMEs or Q banks

Finally, let’s look at some situations where I have encountered students wanting to move their test date up and exactly how it played out:

Student 1:  Scoring above the 250s on 3 straight NBMEs with 4 weeks until their test

To me, this is the easiest situation to advise a student to move their exam date up. Many students that hope for high scores will often give themselves too much time to study as a way of being cautious — only to encounter this situation. Here, my student had completed 3 passes through First Aid, 2 passes through USMLE World, and one through Kaplan’s Qbank by the time this question came up. Seeing little benefit to spending an additional 4 weeks studying, we moved his test date up by 3 full weeks and revised his schedule to focus on high yield material in those final 7 days. Overall, it was a great decision as he ended up with a score well above his goal — and 3 weeks to spend relaxing before third year.

Before I move on, let me elaborate and say that this number doesn’t have to be in the 250s but could be any number that you describe as your goal score. That being said, don’t set your goals too low. A student whose goal score of 235 might be tempted to move their test date up at the point their NBMEs are in this range. However, they should earnestly consider if a higher score would be possible and continue pushing forward if they believe it is.

Student 2: Scoring in the 230s after 8 weeks of studying and feeling burnt out

We have discussed this in several prior blog posts — but burnout is real. I have seen many students happily following an upward trajectory on their performance metrics only to be derailed and decline by pushing themselves for too long. If you notice that your scores on UWorld blocks or NBMEs are starting to consistently decline, it may be a sign that you are burned out.

That being said, don’t let “burnout” become an easy excuse to give up on pushing yourself harder. You should never feel like you’ve settled on a particular score simply as a way of getting this over with. Before I let a student move their exam up because of burnout, I try to let them recharge their battery by taking a full day off or working through some half days. Many times, simply taking your foot off the gas for a 1-3 day period can be enough to recharge your battery and keep you going forward.

For the above student, their score had dramatically risen from a 160 on their first NBME but had spent several weeks slowly moving up from the 220s to the low 230s. Even though their goal score was in the 250s, they did not feel like they could spend another 3 weeks studying and opted to move their exam up by a whole 15 days. At that point, we adjusted their schedule to emphasize high-yield topics and areas where they had struggled throughout in order to maximize the value of their time. Ultimately, their score was in the high 230s — and while this was lower than their original goal, it was better than what could have happened if they had continued pressing on into burnout.

Student 3: Scored a 225 on their final NBME and decided to move their test up by 20 days

Unfortunately, moving your test date up doesn’t always work out. Here, I had a Step 2 CK student who had only recently completed their first pass through USMLE World and still had two NBMEs to go. Additionally, he had many troublesome subject areas that were bringing his scores down — which meant lots of areas for improvement if he could keep pushing himself further. Still, he had convinced himself that he was burnt out and that the NBMEs were underrepresenting what his actual score could be. Despite my reservations, he decided to push his test up by 20 days, leaving himself only two more days to prepare for his test. Hoping to be proven wrong, I was definitely disappointed when I saw that he had passed by only a few points.

The moral of this story isn’t that I am always right (because I certainly am not). Instead, I am using it to highlight that if you are moving your exam up, you still need to give yourself enough time to modify your schedule accordingly. I have no way of knowing exactly how well this student could have done, but I am convinced that his score would have been higher with even 3-5 more days to study.

 

In conclusion, I hope you don’t think I am crazy anymore and realize that moving your test up can be a very viable option in the right situation. And as always, if you need to talk or have any questions, please leave a comment below.