The Importance of Post-USMLE Step 1 Decompression

  • Reviewed by: Amy Rontal, MD
  • The period of time immediately after taking Step 1 may be an emotion-fueled one. Here is an unpacking of what you may expect and how you can plan on moving forward from the exam.

    What to anticipate after taking USMLE Step 1

    Step 1 test scores are generally released on Wednesdays at 11 am EDT/EST approximately two to three weeks after you take the exam, though they may be delayed upwards of one to two months in rare instances. During this time, in most cases, you will receive no correspondence from the NBME.

    Upon walking out of the exam center and in the subsequent days, it is perfectly natural to experience any range of emotions. Some will feel comfortable, others mildly uncomfortable, and still others very concerned. If you are worried that you may have failed the test or fallen short of your goals, it is important to recognize that you are not alone and that many others have felt similarly only to find they did very well. Equally crucial is to take certain steps and avoid others to help you enjoy this brief transition period in your medical education.

    Read our 2019 USMLE score reporting report and our Step 1 score reporting FAQ for more info on what to expect for Step 1 score reporting!

    How to decompress after taking Step 1

    Some people may derive quite a bit of benefit from finishing their study period, taking the exam, and then immediately beginning their first or next rotation in the hospital. That said, you should consider affording yourself some time in your schedule to decompress after the exam. The best way to handle post-test emotions is to identify healthy ways to distract yourself with what you enjoy.

    One great idea is to build a vacation immediately after the exam into your schedule and go out of town. First of all, knowing during your study period that you will have this time for relaxation afterwards may function as a so-called light at the end of the tunnel. Furthermore, in staying busy while traveling, you are far less likely to think about questions you answered wrong or about that one section where you were running short on time.

    However, if you do not have the energy to plan a trip or do not enjoy traveling, there is no single thing you absolutely have to do during this time. The point is that, if you elect to use this time to decompress, you busy yourself doing what you love.

    What not to do while waiting for your Step 1 score

    The single one item you should above else not do is try to scour the internet and find the answers to questions you did not know. While learning a guessed answer was correct might feel great, realizing that you made a mistake or overlooked something obvious will be far more frustrating and anxiety-inducing. Furthermore, it is almost inevitable to focus exclusively on where you were wrong without realizing how many more questions you answered correctly. As explained earlier, what is far healthier is to suppress this temptation and simply celebrate having taken the exam while you await your score.

    Another activity to avoid is assuming the worst or considering the scenario that you might have fallen short of your goals. In other words, this is an instance where hoping for the best but planning for the worst is not a productive pursuit. As mentioned before, when you cannot control what will happen, the best option is to wait patiently and occupy your time with healthier pursuits.

    Finally, because the exam is graded on a curve, it is next to impossible and thus not worthwhile to attempt to predict from your subjective test-day experience what the outcome will be. While the algorithm for how the exam is graded is not published, it may be assumed that many questions you found challenging were challenging for other test-takers and that this will be reflected when your raw score is converted to the three-digit score. You can still meet and even far surpass your goals even if the exam you took was a more difficult one.

    Step 1 scores in a nutshell

    The bottom line is this: After you finish the exam, celebrate for as long as you would like and your schedule permits and in a way that is a healthy outlet for any nervous energy you might have after completing this milestone. You earned it and deserve for the period after your test to be one of enjoyment and not worry.

    Are you wondering if you should move your Step 1 test date up?

    Here are our tips for surviving Step 1 test day.

    USMLE Score Reporting: What to expect

    The 2019 USMLE Score Reporting Report


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