Am I ready? The question at the heart of every USMLE study plan

So you booked your USMLE, you’ve been studying using the top resources and you think you might be making progress, but then this silly guy comes around and gives this great method and your wondering what to do *coughhumblebragcough*. To answer this we have to ask why we take USMLE in the first place… to get a residency.

If you haven’t already, you need to take an NBME or Uworld self-assessment exam, ideally after doing four blocks of something else, to simulate the real exam. You should then take that score and compare it to the average USMLE score for  match applicants I provided below for your desired residency. I can not tell you how many times I hear a student go into USMLE without having atleast a few NBMEs under their belt and are then surprised by their score, typically for the worse. You NEED to know where you are tracking before you go into this exam.


If you scored at or above the average for your desired specialty, and are within two weeks of the exam I would recommend you stick to what you are doing and do not change it. Changing things up so close to the exam may do more harm than good when you are already near your desired score. I’ve seen so many good student shoot themselves in the foot by pushing their test just to get that “high score” which wouldn’t have made a huge difference in matching into a residency and , in the end, hurt more than help as it through them off cycle or worse even lowered their score. On the flip side of that, if you are not within five to ten points of the exam average for your applicant type and your test is two weeks or less away you could consider pushing the test .



What if you didn’t do so hot and decided to push it, now what do you do? Well considering you should now have six to eight weeks more to study, simply follow the method I laid out previously. Make a schedule, do high yield subject (Pathoma, FA, picmonic ( or other memory tool like anki) for Step 1) ( Onlinemeded MTB Step 3, FA Board and Wards for Step 2CK), then the corresponding Uworld section (tutor by section, allowing 1 minute per question and reviewing after every 10 – 15 Qs), taking a full NBME at 4, 2 and 1 week out to ensure you’re on track and prevent test fatigue on game day.  Congratulations, you now have enough time to implement the entire system.

Now what if you did mediocre (10 – 15 points away from the average) , but you don’t want to/can’t push the exam. This is tricky but basically you’ll have to use your breakdown as your guide. Were you lacking in a few section while doing really well in others? Then you are likely lacking in fundamentals in that particular subject and therefore should do those sections only and redo those Uworld sections as outlined in my previous article ( tutor mode by section, one minute per question reviewing after every 10 to 15), then go back over your marked questions for the other sections by clicking review and read the learning objectives, bolded words and graphs.

If you find you are low-mediocre in all sections then you are lacking in general fundamentals, so you’ll have to review all sections then do/review all UWorld questions. You likely won’t have enough time to review all the answers so you’ll have to stick to learning objectives, bolded words, and any attached pictures/graphs/tables. This isn’t ideal but neither is your situation so we have to maximize time as much as we can. Right before the test re-read your high yield resources very quickly and then the learning objectives in Uworld.

A final word on how important when you take the test actually is. From my experience a better score will always trump a lower one as long as your scores go out so that you don’t have to take any time off (for Step 1)and your application scores go out before Oct 1 (for Step 2CK) when applying. As an example I applied to forty University programs on the last day of September and heard back from the many of them. With this said for the cream of the crop top programs having everything in on the first day with no breaks gaps in your schedule could make the difference between getting or not getting an interview as they typically get so many qualified applicants they get very choosey early on.

  • Look at the charting outcomes pdf found at the website below where you fit ( U.S. IMG, AMG etc) and find your desired specialty and ensure you are at or above the average score on at least one but ideally two practice exams.
  • Below is the Website where Charting Outcomes can be found: