How to Improve your USMLE Score Consistently

Today, I want to discuss a topic that's crucial for many medical students: how to ensure you're making progress when studying for the USMLE (United States Medical Licensing Examination). There's nothing more frustrating than dedicating months of your life to study and not seeing any improvement. (I am sure that you have heard people fall into this perpetuals trap before). I understand that resources like UWorld or AMBOSS are learning tools, not assessment tools, but you still need to demonstrate improvement. Why? Because while the questions themselves may not repeat verbatim, the concepts behind them often do. The last five or six blocks of questions in your USMLE practice matter significantly. If you're not improving by the time you finish your resource (like UWorld), it means you're getting the same concepts wrong when they come up again. To secure a high score, you must demonstrate progress!

Now, let's address how to improve. Understanding concepts, memorization, and applying knowledge are the key factors that determine your USMLE score. However, the real question is, what activities should you engage in to achieve these goals? Is it watching videos, reading books, or doing practice questions? Most students might think it's doing practice questions, but that's not entirely accurate. What truly improves your score is the act of REVIEWING.

Consider this: if you answer practice questions without knowing why you got them right or wrong, how can you improve? The magic happens during the review process.

Now, I'd like to highlight three crucial aspects regarding how you should approach your review.

1. Maintain a 1:1 Review Ratio

One common mistake student make is spending less time reviewing than they do answering questions. If you dedicate an hour to completing a block of practice questions, allocate at least an hour for reviewing those questions, at least maintain a 1:1 ratio, meaning you spend as much time reviewing as you do answering questions. You can certainly do more in the beginning, like 1:2, or even 1:3 ratio (1 hour of questions and 3 hours of review). I firmly believe that in the future, as you progress, you will spend less and less time to review because a lot of the content is repeated.

2. Review Every Single Day without Fail

Make reviewing a daily priority. Even if you have other tasks or materials to cover, always ensure you allocate time for review. If you must choose between doing new questions or reviewing, prioritize review. Consistency in reviewing is what ultimately drives your score improvement.

3. Active Learning During Review

Lastly, let's talk about how you should review. It's not enough to passively read explanations or notes. You must actively engage in the review process. So, it's not only putting more hours in your review, but, the quality of your review is very important. Review actively means drawing diagrams, recalling information from memory, and actively working through the material rather than simply reading it. This force your brain to think and recall (high level of cognitive load), which has been proven to improve learning process.

Tools like Anki, with its active recall and spaced repetition features, are excellent for active learning during review. Anki can ask you to redraw diagrams or pathways, ensuring you're not just passively absorbing information but actively engaging with it.

In conclusion, to ensure that you improve, you want to engage and put more emphasis in the review activity. Remember these three key points: maintain at least 1:1 review ratio, review every day, and actively engage with the material during your review sessions. 

Yulius Haryadi MD