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Knowing the material for the USMLE is one thing. Being able to demonst=
rate that knowledge on the actual exam is something else.
Over the years I have worked personally with a hundreds of students wh=
o seem to have mastered the essential medical knowledge required for the US=
MLE, yet still do poorly on the exams. All of this has led me to a simple c=
onclusion: there a many, many ways to do a question incorrectly, but really=
only one way to do it right. Having the right method when doing a question=
will not guarantee that you will get the right answer, but it does help yo=
u leverage what you know to the maximum advantage.
Some people have internalized these steps and do them intuitively, wit=
hout any conscious awareness. Others need to spend time learning these step=
s and use them consciously, until they are an internalized habit. Remember =
that test taking is not a genetic endowment, but consists of entirely learn=
ed behaviors. If you have not yet mastered the basic steps of answering USM=
LE questions, now is the time to learn.
Think of each USMLE item, not as a single question to be answered, but=
as a clinical problem to be solved. The pathway to that solution is found =
by completing a series of 8 simple tasks. Each of these tasks solves one of=
the cognitive problems inherent in a USMLE question. Completing each of th=
e 8 tasks in sequence leads you from uncertainty to your best possible effo=
rt on each question. The goal of these steps it to ensure that you gather t=
he clues provided by the questions stem, think about them in a meaningful w=
ay, and then make a choice before moving on to the next question.
These 8 steps can be briefly described as:
4. Order of Importance
Some things matter more than ot=
hers. Most questions will present you with, not one, but several points of =
significance. Your task is to sort out: What is the most important issue? I=
f several medical problems are described, which one should be the main focu=
s of your attention? If several facts are detailed, which one should carry =
the most weight as you sift though the different answer choices in you mind=
? Sorting what is primary and what is secondary will help you focus on the =
core medical issue being tested.
9. Lock in a Choice
And lastly, MAKE A CHOICE! Having =
processed the questions stem, reflected on relevant content, and reviewed t=
he options=E2=80=94it is time to choose. The biggest time waster in the exa=
m occurs right here as students hesitate and vacillate. Make that choice, l=
ock it in and leave it. It's time to move on to the next question. Forget s=
econd-guessing yourself. A question once answered is over. Move on.
Table 1. Eight=
Steps to Working Though a USMLE Question.=20