Home » How to Prepare for Your USMLE Step 1 Test Day

How to Prepare for Your USMLE Step 1 Test Day

14 min


Medical school students taking their USMLE Step 2 exam in a prometric testing center.


Thousands of UWorld questions, endless Anki cards, and countless sleepless nights later, you’re ready to take on the USMLE Step 1! But what should you actually do to prepare for test day? After weeks to months of studying for such an important and challenging test, you might run up again many last-minute logistical details and questions about preparing for the USMLE test day itself. In this guide, I’ll go through several such considerations and commonly asked questions.



Should I Request USMLE Testing Accommodations?


This is one of the most common questions we receive from students and should not be a “last-minute” question, but I’ll address it here. As with other standardized exams, testing accommodations can be provided to students taking USMLE exams based on their needs, whether that is extra testing time, extra break time, etc. Deciding whether or not you may need accommodations is a personal one and one that needs to be made well in advance of your test date. You may need to provide documentation of previous testing accommodations and/or your learning/physical/medical disabilities or disadvantages that warrant certain accommodations. My advice is to look into these very early in your test planning stages. Once you know you will have accommodations, practice doing questions and practice tests with the same accommodations you will have on your test date. 



Should I Study the Day Before Step 1 Test Day?


Most test-takers feel the pressure to study up until the last minute before the exam. After all, there is so much information covered on the USMLE Step 1 that you feel there is always more to learn. However, giving in to this pressure can often be more counterproductive and further heighten test anxiety. My advice is to minimize studying the day before test day and instead focus on relaxing and ensuring that logistical details are in order. If it would help you relax to look over and review a couple of things, I would try to limit that time to 1-2 hours. 



What Should I Do the Day Before the USMLE Step 1 Test?


If not study the day before, what should you do? The day before your USMLE Step 1 exam can be an anxiety-provoking time. But here are some strategies to mitigate this and set yourself up for success:


Organize your documents


Be sure you have a copy of your testing registration paperwork as well as your government-issued ID that you will need to present on test day.


Travel early


If you are traveling to take the exam in another location, if at all possible, try to get there early the day before. You don’t want to arrive at your hotel at 10 pm the night before your exam only to find out there was an issue with your registration and have to make alternate sleeping arrangements last minute. 


Check out your testing center


If your testing venue is local and easily accessible, you can take a quick trip to the site the day before to see exactly where it is. Take this time to look around the non-testing areas. You can check whether there are restrooms nearby and whether there are water foundations. You can also confirm they have lockers for your belongings and how big they are so you don’t accidentally bring a bag that’s too big, and if a fridge is available to store your lunch.


Eat and hydrate well


Everyone has a different diet and foods they’re used to, so make sure you eat foods that you tolerate well. In general, avoid heavy, greasy, or spicy meals. Be sure to hydrate well.


Try to relax!


As mentioned above, take the day off studying and focus on giving your brain a break before a long 7-hour test day. For some people, this might mean getting some exercise and going for a walk or jog. For others, it might be the afternoon hanging out with friends or family. But try to find something to get your mind off of UWorld and Anki.


Pack your bag


Before the end of the day, make sure your bag is all packed with your ID, admission ticket, earplugs, snacks, and any medications you need. Shop for any snacks you may want on test day. Pick things that you would eat at room temperature and will not need to be refrigerated or microwaved since these appliances may not be readily available at your test site. Be sure to bring some water and any caffeinated beverages (should you normally use them) as well.




I cannot overstate the importance of good sleep the night before a long USMLE test day. Try to stick to your regular sleep regimen. Avoid using any new sleep aids or medications that might increase the risk of oversleeping. If you’re traveling to take your exam, be sure to pack earplugs in case it’s noisier than anticipated. 



What Should I Do the Morning of My USMLE Step 1?


Wake up early!


You don’t want to oversleep and miss your exam. Err on the side of waking up early so you have plenty of time to get ready in the morning and avoid rushing to the test. 


Eat a nutritious breakfast


Eat a nutritious breakfast to fuel your body and mind. But avoid overeating and steering too far from your routine. Foods such as whole grains, proteins, and fruits may be good options.


Dress comfortably


This is one of the most important yet neglected points in preparing for your test. The USMLE Step 1 is a long test. You will be in the testing room for up to 7 hours, and you don’t want to be uncomfortable. While most testing centers should have adequate heating and air conditioning, prepare for some fluctuations in temperature, and bring a light jacket in case the room is a bit too cold for your liking. On the other hand, try to avoid wearing heavy coats or thick sweaters since it may be too warm.


The other aspect of your attire to consider is that as part of security measures. The testing center will make you check in every time you enter and exit the testing room. This process will involve pulling up shirt sleeves and pant legs and turning out every pocket, among other things. My advice is to avoid wearing clothing with a lot of pockets and sleeves that are too tight or difficult to roll up.


Plan your breaks


This is something you should do well in advance of your test date but it’s good to think about your break strategy before you start. The USMLE Step 1 offers 45 minutes of break time. If you skip the 15-minute exam tutorial in the beginning, you will start with 60 minutes of break time. In addition, any remaining time from sections you finish early will be added to your break time. I generally recommend taking 5 to 10-minute breaks between each section, though some people prefer to take shorter breaks and take 1 larger 20 to 30-minute break halfway through for lunch. Figure out what works for you early in your test preparation by trying different break strategies when you take practice tests. During each break, drink some water, use the restroom, grab a bite, and take a quick stretch to refocus.


Arrive early


Get to the testing site early so you can familiarize yourself with the environment and not feel rushed going into the exam.



How Do I Stop Being Nervous for USMLE Step 1 Test Day?


Being nervous is natural. The USMLE Step 1 is a difficult and high-stakes exam, and being anxious about your performance is completely reasonable. But trust the hard work you’ve put into this process and how much you’ve learned over the past weeks to months of studying. Remind yourself that to get to this point you’ve passed several premed courses, the MCAT, and many medical school exams. However, if anxiety is significantly affecting your performance or quality of life, consider speaking to your advisors and/or a mental health professional who can provide strategies and support. Remember, passing USMLE Step 1 is an essential step in your medical career, but it’s just one part of the journey. Stay focused and positive!


For additional USMLE Step 1 or Step 2 help, consider enlisting the help of an Elite Medical Prep tutor. Schedule your complimentary consultation today to learn more about how we can help you succeed!

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