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Should I Use Multiple Qbanks for USMLE Step 1?

I remember when I started Anatomy in my first term of medical school, I would sit there in my cubicle in the library staring at Netters. I would then take out my 4,000 colorful pens and blank paper and try to re-draw everything I had just seen. By the time the test day came, I was able to essentially mold the human body from a block of clay with my eyes closed.  But guess what? I failed my first Anatomy exam. 

I remember one of my classmates asking me, “Didn’t you do Grey’s questions?” My answer: “Yeah, I mean, I did some of them!”

This was one of the most pivotal moments in medical school for me, when I realized that learning medicine from the ground up meant nothing if you didn’t know how to apply it. The truth is, unless there is a clinical correlate, who cares if you know all of the innervations of the coccygeal nerve? Unfortunately, while being a good doctor isn’t all about doing well on standardized exams, it’s how we are being evaluated now. It’s because of this that you must learn immediately (if you haven’t already) that DOING QUESTIONS IS ESSENTIAL. Learning through questions is the best way to test your knowledge and make connections, and it is by far the most efficient way to study. 

For those of you who are already convinced of this and are about to embark upon Step 1 studying, you are probably wringing your hands trying to decide on which Qbanks you want to incorporate into your action packed study schedule. I promise, I am not being paid by USMLE World, but can we all just agree that UWorld is by and large the best Qbank to prep for Step 1, and if you aren’t using it, you are doing something wrong (#sorrynotsorry). The bigger question that students often ask themselves though is: 

During my dedicated Step 1 study period should I

  1. Do UWorld multiple times?
  2. Do UWorld once then switch to another Qbank?

These questions are very common. Whenever I start working with a new student, he/she is always skeptical when I have them scheduled to work through UWorld twice, and generally say “no” to incorporating other Qbanks (Kaplan, USMLE Rx). This can be very scary for people.

Here are the top 4 reasons why we fear using only one Qbank (and why we should fear not):

(Don’t be surprised if you’ve either said these things or have heard your peers say them.)

1. “Some of my friends are using other Qbanks in addition to UWorld”

Resource FOMO anyone?  There is nothing worse than feeling like other people are doing the right thing’ and you aren’t.  The reality is, everyone has very different learning styles.  Just as you shouldn’t choose your Step 1 prep method based on what your friends are doing, you shouldn’t be choosing your Qbank based on what others are doing.  You always should do what is right for YOU.  Furthermore, this advice is coming from someone who has gone through this process and excelled, rather than someone who hasn’t even taken the exam yet!

2. “I don’t want to miss out on any content”

First of all, don’t you already have ENOUGH content to review? You should be studying from First Aid, BRS Physio, Pathoma (or something similar), and UWorld. If you can truly say “I know everything in these resources already,” then you probably don’t even need to do any more questions at all. Just take the test already then! But in all seriousness, you aren’t going to get any more additional information from another Qbank that is necessary to know that isn’t already in one of these other resources. 

3. “I want more questions that I haven’t seen before”

Some people who finish UWorld for the first time think that when they restart the Qbank, they will remember the questions and only pick the right answers because they remember what the answer was before. I have 3 things to say about this.

First of all, I can personally guarantee that you will never remember 2000+ questions the second time around. Furthermore, UWorld has the tendency to reuse very similar question stems changing a small detail to test you on whether or not you really know the content. The stem may be familiar, but that doesn’t mean you will remember the answer. 

Secondly, there will be times when you get a question that tricked’ you before, and you remember the reason why what you originally chose was wrong. Well guess what? That’s called learning! What better way to reinforce these confusing topics then to see them again?

Thirdly, doing questions isn’t JUST about answering the question; 75% of its importance is in reviewing the answer, and UWorld has the most thorough, well-organized explanations of all the Qbanks.

4. “I should be seeing different question formats to better prepare me”

All I really have to say about this is “meh.”  I mean, all question banks are now focused on clinical vignette formats. The difference is usually the length of the vignette or some of the wording. Of all of the things to focus on, this is one of the least important. Yes, other Qbanks will offer slightly different question styles, but nothing so drastic that will make a difference in your score. Especially when you take into consideration the benefits of redoing the UWorld Qbank.

So, what is my advice exactly?

My philosophy has always been “do what is best for you,” but sometimes we don’t know what is best for ourselves! My advice to the MAJORITY of students who are taking 1-2 months of dedicated study time for Step 1 is to do the UWorld Qbank exclusively (not counting NBMEs), and to do it at least twice. All this said, there are always exceptions. There is a subset of medical students that actually have gone through all UWorld multiple times before even starting their dedicated study period. To these students I recommend incorporating the other Qbanks, but more importantly, to take an NBME to see where you are you may just be ready to take the test NOW. For the rest of you: redo UWorld before moving onto the next! In doing this, you will not only reinforce everything you have learned in doing the questions once, but you will pick up on new facts along the way from the number one Qbank available.