Your Final Countdown to the USMLE Step 1

  • /Reviewed by: Amy Rontal, MD
  • Time is short and test day beckons. T minus 2 weeks. Usually at this point, students fall into one of two camps. Student A’s study plan has held up, s/he is cruising along, and feels like s/he is in a pretty good spot. Student B had made an overzealous study plan, hasn’t been able to keep up, and is having trouble treading water and staying afloat, losing confidence with each passing day. Which of these students benefits from the help of a tutor in their final two weeks?


    Let us break it down:


    First of all, great job. Getting to a point of comfort (and maintaining it) during your study period is difficult. Take a little bit of pride in the fact that things have come together nicely thus far. Right now, you’re feeling good. But are you in the absolute best spot possible?

    No doubt that you have thought about score at least once (and likely 250 times) by this point. Like most students, you likely have a range you expect to “fall into” based on performance in class and on NBMEs. (You are taking NBMEs, aren’t you?) And on top of that, you’ve probably established a reach score; that score above which you will be ecstatic and go into interviews with total confidence that you are very competitive for your chosen specialty. Even if you aren’t striving for an ultra-competitive specialty, you would like to be held in high enough regard to be choosy. You yearn for the confidence that you can match into the program you absolutely loved.

    Working with an experienced tutor can take your score from solid to amazing.

    We are all scientists, and we know that experiments are reproducible. If variables are not changed, we can expect a similar outcome, within a standard deviation in either direction. If you are plateauing subjectively (feeling stuck) or more importantly, objectively (stagnant NBME scores), then it’s time to add a new variable to your equation and shatter through the plateau. A tutor in your final two weeks is that missing variable that takes you to the next level.


    First of all, stay calm. You are not the first medical student to be in this position, and you certainly won’t be the last. In fact, having the insight that you are in a tight spot is the most important discovery you could have made. In the two week timeframe, a tutor will shine the guiding light to help you make the most effective use of limited time. They will help to triage information, assess your deficits, and build a bulletproof, individualized study plan for you. Not only will this help your deficiencies, but it will help to quell the anxious voice inside, and transition you to a pedestal of confidence. If it is clear that you would benefit from some outside help, why not take advantage of someone who can offer their expertise and guidance?

    No matter which student you are, tutors can help in a number of other ways. Something that we see quite frequently is a student who feels that they are just not ready. And this never comes as a surprise. Even the most well-prepared student can feel apprehensive as test day approaches.

    With the extremely broad fund of knowledge necessary to excel on USMLE exams, very few students get to the point where they are confident enough to say “I’ve got it all internalized!” A tutor can be the objective voice of reason to be 100% honest with you, and tell you when you are ready. And if you truly aren’t, he or she can guide you to postpone if absolutely necessary. This mental aspect of confidence is incredibly important, and your tutor can help you build it up, getting you into top mental shape as you finally approach the test.

    Tutors also provide accountability. Not everyone has the discipline to keep studying hard during the home stretch. It is easy to let your guard down a bit after weeks of aggressive preparation. Your tutor will keep you sharp during your final stretch, and will help you find that all-important balance between working hard and burning out.

    Lastly, a tutor will be able to adequately assess your knowledge after you have had a pass through the material, and help you identify strengths and weak points to work on in your final two weeks. This final pass of the material is incredibly important; it is your last opportunity to master heart sounds and kidney biopsies and HIV prophylaxis guidelines and the likes. Your tutor can be an invaluable resource in partitioning out your limited time into the areas that need it most. These areas can be tough for a student to identify, but simpler for a tutor who knows what level of knowledge is necessary for excellence.

    One of the most important things you will realize in your medical career is to ask for help when you need it. This is true for students and residents alike. You have at your disposal, the knowledge and experience of those who have been in the same exact position as you. Not only that, they have helped guide and teach those in your position. You wouldn’t throw in your first central line unsupervised after reading the manufacturer’s instructions and watching a few YouTube videos. Taking USMLE exams should be no different. Utilize and exploit every asset available, and you will maximize your chances of a top score, and ultimately, land the residency that your heart desires.