Justin P., editor for USMLE Benchmark, explains some underused question bank strategies that hone your test-taking skills.

According to Justin P., editor for USMLE Benchmark, medical students can underestimate the importance of practicing test-taking skills in preparation for Step 1. “I had friends in medical school with me who came from the UK. They were very smart and studied very hard,” he says, “but they all completely bombed their first test. They had almost exclusively taken oral exams in the past, so they studied the same way. Their experience is evidence that there is a specific skill to taking a multiple choice test. I think you need to practice that skill.” Below, Justin explains how Step 1 questions are structured and how test-takers can best use question banks to prepare to tackle Step 1.

How do question bank editors write Step 1 questions?

“The question writer is never trying to trick you,” says Justin. Justin tells us that the text of the question will provide the basis for the inferences you must make to arrive at the answer. Many medical students study buzzwords, or keywords, that appear in the text of Step 1 questions, from which you directly infer a certain condition. “There are some question banks, and even review books, that focus on buzzwords,” he says. “When I was studying for Step 1, buzzwords were heavily emphasized.” Justin tells us that Step 1 questions always require more than one inference so relying on buzzwords alone will not be sufficient to arrive at the answer.

“When I include a buzzword as I write a question, I make sure the question requires at least two inferences to arrive at the answer. The ability to recognize a disease based upon a buzzword is important, but in order to get the question right, you’ll need to draw a second inference about the disease.”

What are the best strategies for improving your test taking skills?

1. Answer questions under test-like circumstances to improve your stamina

“Even if you are a good multiple choice test taker,” says Justin, “most standardized tests you have taken in the past are not quite as long as Step 1.”

“The ability to put yourself in a real life test situation is an underutilized function of question banks. There is so much anxiety going into the testing room, including anxiety that derives from the simple fact that they fingerprint you and sit you in front of the computer,” says Justin. Justin explains that question banks can be used to work on your endurance as well as your recall of content, and the former can be achieved by simulating the test-taking experience with question banks. “You’ll need to get used to the experience of answering four hundred questions in one day. It’s exhausting.”

We learn from our failures. Getting questions right is nice, you will learn more from your mistakes.

“During a dedicated period, after classes end, I would do two full length tests in various question banks,” he says. “You’ll have to make up your own tests, at least two blocks per week, which is 40 straight minutes of questions from a variety of topics.”

2. Track your confidence level on your answer choices

Question banks are your best friend when it comes to assessing what you know and what you don’t know. “It is hard to know what you don’t know,” says Justin. “Often you may find yourself saying ‘I just read that chapter a few times. I think I know musculoskeletal really well.’ But, how do you know that? You have to test yourself with a question bank to find out,” says Justin. “We learn from our failures. Getting questions right is nice, you will learn more from your mistakes.”

Justin explains that tracking your confidence level for each question allows you to pinpoint your weak areas. “That ability to mark questions you were not confident in is a really powerful tool. With Benchmark, the question bank I work for, you can mark questions on a confidence scale of 1 through 6. A week or so after your self-assessment, you may find yourself reviewing answer choices and feeling pleased that you got certain answers right. Tracking your confidence allows you to clearly see which answers were guesses and which you felt only somewhat confident about.”

In summary, to study effectively using question banks, make sure you understand what is expected of you in answering Step 1 questions. During your study period, put yourself in test-like conditions to improve your stamina and test-taking skills. Last, as you study from question banks, track your confidence level on each question and use this information to assess your preparedness for Step 1.