I Failed the USMLE®. Now What?

You’ve received results from the USMLE® Step 1 Exam and they’re not what you’d hoped… Your first instinct is to feel defeated – after spending hours upon hours to study and prepare, a low test score is discouraging. It is normal to feel bad and you should allow yourself a bit of time to have those feelings.

And then, it’s time to put your disappointment behind you and move forward. Time to “get back on the horse!” Don’t quit! You still have a chance to retake the exam, do much better, and Match into a residency program.

Here are a few essential steps to improve your USMLE® Step 1 exam score.

  1. Assess your first attempt. Before you take your exam again, you need to figure out what you need to improve from your first attempt. Simply going back, working harder, and doing more of what did not work for you the first time is unlikely to give you a better outcome the second time. Were there particular subject areas in which you felt unprepared during the exam? How did the real exam feel different than your practice exam or when you were answering Question Bank questions? Did you have issues with timing or anxiety? You have to understand what adjustments you need to make to set yourself up for a better outcome the second time. If you can’t figure out for yourself what you need to change, seek help from an expert.
  2. Set new study goals. You need to treat this second attempt as if it is your first. That means you must re-review everything. One of the most commons mistakes we see is that students only focus on subjects where they performed poorly and neglect the ones in which they did better. If you do not review everything again, you will find that your weaker subject gets better, but your stronger subjects fall, putting you at risk for failure a second time. If you are uncertain how to allocate your time as you study for your second attempt, get expert help to walk you through the process and help you define a schedule. Doing the same thing that you did to study for your first USMLE® attempt is not likely to be very useful.
  3. Don’t redo the same practice questions you did for your first attempt! You need practice at thinking on your feet and problem-solving. Redoing questions is a memory exercise and a waste of time. If you have used up all of the UMSLEworld questions, I remind you that Becker has a questions bank of over 2,200 tough, thought-provoking questions to get you back in the groove. Remember that you should do practice questions, not so much to get a score, but to get guidance for future study. The questions you miss tell you what topics you need to go back and review again.
  4. Focus on thinking and understanding WHY! The USMLE is not a memory exam, but an exam which test problem-solving and clinical reasoning. Most people who fail on their first exam attempt focused on brute memory and the use of mnemonics. You have to be able to take the information presented in the questions stem, realize what matters, and pick an answer which reflects that. Memory is the base on which you build. Good exam results are the result of understanding how things fit together and what presented information means for patient care. If you need practice learning the clinical reasoning component, consider enlisting expert help to show you the process and help you practice.
  5. Believe in yourself! You can do this. A slip and a fall does not mean you will be down forever. Character comes from how you respond to your setbacks. Don’t let your test performance define you as a person. Success is earned. The path to being a physician is still open to you. It’s time to reset, regain your resolve, and rededicate yourself to that effort. Success comes from persistence. It’s time to show what you can do. Becker is here to help!
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USMLE Faculty and Curriculum Director at Becker