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The Secret USMLE Study Skill that No One is Telling You

One of the highest obstacles to overcome when approaching medical school curriculum is dealing with the astronomical volume of information that you’re expected to memorize. At MST, we speak a lot about the importance of selecting appropriate resources, building detailed schedules and utilizing study aids such as flashcards. All of these are imperative for any student planning to maximize efficiency and score high on Step 1.

However, many of our students come to us expecting far more than structure. They want to know the “secrets” – the things you cannot find in some forgotten corner of the Internet. What they’re really asking, I think, is, “Please help me think like you do so that I can not only memorize this information, but use it effectively.” If you’ve already taken NBME or USMLE exams, you are familiar with the concept of two- and three-part questions. It is rarely enough to simply know the anti-pseudomonal antibiotics.

Here’s what you’re more likely to encounter on the USMLE:

  • A clinical vignette of a young child with recurrent pneumonia
  • Signs of abnormal digestion, such as high stool fat content or fat-soluble vitamin deficiencies
  • At this point, the question assumes you’re on the “cystic fibrosis’ page
  • This means they’re assuming you know that pseudomonas commonly causes pneumonia in patients with cystic fibrosis
  • Now they’ll ask about the antibiotic

Whew! That’s a lot of work to get one question right. If you’re thinking about the way in which your First Aid is organized, you’ll realize that you have to pull information from the genetics, microbiology, gastrointestinal and respiratory sections to get this single question right.

Apart from doing hundreds and hundreds of questions, how should you prepare for multi-step questions by reading and making flashcards alone? I say, you shouldn’t. 

You should be building “thought webs.”

What is a test-prep thought web?

A thought web is a spokes-on-a-wheel type of diagramming technique that allows you to make multiple connections between the material you’re trying to master. This can be done alone (i.e. by drawing on paper or white boards), or it can take the form of a verbal exchange between friends.

Here are some examples of my favorite thought webs:

1-8

2-1

Now that you’ve seen a couple, you can easily see how practicing these on a daily basis can help you with those multi-part questions.

For example, you could be asked a specific microbiology question about EBV, i.e. related to the Monospot test for acute mononucleosis, and wind up needing to know that EBV is associated with malignancies such as Hodgkin lymphoma. To get there, just follow the thought web!

See what I mean?!

How cool is that?!

Now, go practice your thought webs!