For many, one of the biggest challenges of the dedicated study period for the USMLE (or COMLEX) is the isolation inherent to such an intensive 4-6 week block of studying.

Within a few weeks, many students find themselves going stir crazy holed up at home or in the library and seem to be longing for basic interaction. To make matters worse, that interaction is often difficult to obtain as your non-medical friends might have no idea what you are going through while extensive interaction with your classmates during USMLE prep tends to create more anxiety. In hopes of a solution for this, many students turn to USMLE study groups but should they?

Team-based learning has become a very popular trend in medical education and for good reason: it provides you with the opportunity to learn from your peers and helps young physicians develop the cooperative skills necessary to become successful clinicians. However, while this can be effective for active learning in a classroom setting or for block exam preparation, the same is not always true with regard to preparation for the USMLE. So why is that?

In my experience, I’ve seen several key reasons why group study is not effective here. These are:

1. Everyone has a different foundation  When studying for a block exam, you and your study group are typically beginning with the same foundation for the material. However, with regard to the USMLE, each student will begin his or her dedicated study period with their own sets of strengths and weaknesses. So while you might need to devote the early part of your study schedule to physiology and pathophysiology, your potential study partner would be better off tackling pharmacology and microbiology. At the end of the day, your schedule should be based on your needs alone.

2. Everyone learns at a different pace  While you might need 3 hours to finish the BRS Physiology chapter for Cardiology, your friend could need 4-5. This lack of synchrony leads to inefficient studying as group members are frequently asking questions that not everyone has covered yet.

3. You make each other more nervous  How does it make you feel when your friend scored a 75% and you scored a 45% on the same three UWorld blocks? More often than not, group studying leads to constant comparisons amongst group members that will only worsen the test taking anxiety.

4. You end up trying too many things  Very rarely is a group 100% in sync with regard to what resources they will be using and how exactly they should use those resources. As a result, I have noticed that many group members end up pulled in too many different directions either trying to accommodate each member of the group and respect their resources or acting out of fear of missing out on a valuable resource.

With that in mind, I do not recommend that students spend the majority of their dedicated study period working in groups.

However, I do think that group work can be an effective adjunct when done correctly. So how do you do this?

1. Know the group  You should be working with people with whom you have studied before, who you know to be reliable, and who have similar goals as you. Additionally, the group should be filled with members that have a diverse collection of strengths, an ability to explain difficult concepts to the group, and the motivation to make the most out of meetings.

2. Meetings should be infrequent, but highly structured  At most, your study group should be meeting for no more than four hours. Prior to meeting, your group should establish a clear itinerary of what will be covered in the session and what each group member is expected to have done prior to coming.

3. Review USMLE Questions The most effective study groups that I have either seen or led tend to use their meetings to review blocks of UWorld questions. For instance, when I was tutoring Step 1 as a fourth year, I had a group of six students that would meet for four hours each week to review previously completed UWorld questions. Prior to meeting, each student was expected to compose a list of 15-20 questions that they struggled with during the week. Using the unique question ID number, each question was then pulled up in front of the group so that each group member could take turns explaining the concept and offering suggestions for test taking strategy.

4. Avoid comparisons  DO NOT use your meetings to compare NBME scores, UWorld percentages, or your overall progress in your study plan. This is the quickest way to derail a session and/or make yourself more anxious.

I hope this advice has helped you and that you now have a better idea of how to make the most out of a USMLE study group and an understanding of why most of your work needs to be accomplished on your own. And just remember: If you need to take a little break to spend some time around people  meeting for a beer and a burrito (or winning a pie eating contest) can be just as fun as studying.