Pushing Back your USMLE Test Date Without Losing Knowledge

Pushing back your Step 1 Test Date Without Losing Knowledge

“When life gives you lemons, make lemonade.”

The coronavirus (COVID-19) crisis is a global pandemic. In this time of great uncertainty, many medical students may be wondering how to best prepare for their USMLE examinations– when they don’t know when they will be able to take their test. Last week Prometric announced temporary test center closures in the United States and Canada until at least April 16th. This action, while necessary in order to help prevent the spread of COVID-19 according to the CDC, has forced many medical students to reschedule their exams. While the Educational Commission For Foreign Medical Graduates (ECFMG) plans to extend eligibility periods for all examinees who currently have a scheduling permit with an end date in 2020, and Prometric has promised to waive all rescheduling fees for students, there is still no question that an unanticipated need to reschedule your USMLE exam is stressful. It’s especially stressful knowing that when testing centers ultimately re-open, there will likely be increased demand and some difficulty in finding open test dates that fit your schedule.

Since it might be a little while until you are able to sit for your USMLE exam, we wanted to make a blog post addressing the two questions we have been getting frequently since the outbreak of COVID-19 in the United States:

1) How do I study when I don’t know when my test date is going to be?

2) If I had to reschedule me test, how can I retain all the information I’ve been studying for another month(+)?

To jump right into answering both of these questions– we believe that focusing on the fundamentals of USMLE studying will be always be helpful when preparing to take any Step with or without a definite test date. Focus on the fundamentals is typically the advise that we give to medical students who want to begin preparing for Step 1 during MS1 and don’t know their test date yet. But, there’s a reason we consistently put so much emphasis on the fundamentals– they’re important. And, generally speaking, the longer you are able to focus on them, the better your outcome will be.

But, what are the fundamentals?

One important part of building fundamentals includes having a method of incorporating spaced repetition to improve long-term memory consolidation and retention of facts. While this sounds very fancy, what we are actually talking about is Anki cards. (Some students will also use a few of the many premade study decks like Zanki or Brosencephalon, among others, that can be imported into Anki. While there is certainly value to using some of these decks, there is often added value by tailoring Anki to best fit one’s own weaknesses by making personalized Anki cards.

For example, a strategy I’ve recommended with many of my own students involves converting the essence or even “educational objective” from a UWorld question into an Anki card, for any question which the student feels unsure about.

So that’s our first fundamental part of studying for the USMLE. Make sure that you have a good personalized flashcard system down that includes making cards of concepts you feel uncertain about.

Also, as a pro-tip, generally speaking, limiting new Anki cards to UWorld helps to achieve the best balance between not creating an Anki card for everything (where one may experience diminishing returns) and not creating enough Anki cards. Anyway, bottom line, whatever method of Anki one chooses, utilizing spaced repetition to one’s advantage gives the student a leg up in their preparation in times of uncertainty such as we currently face. This is because it essentially allows one to have a method of “background” studying that helps retain facts over a longer period of time. Each day, by ensuring that you review your “due” Anki cards and rate them accordingly, you will be building a long-term memory bank.

The second fundamental of USMLE studying is having a structured daily schedule. Despite not knowing for certain when the “end game” or test day ultimately will be, it’s still important to have a study schedule that you take seriously and stick to.

For now, have a target as though you were planning on taking the examination at your currently scheduled test day. For many students, this is in the late Spring and early summer months around May to July. If your test date was supposed to be in the next 30 days and you will have to reschedule, pick a date at the end of April to be your “test date” and commit.

Daily schedules should be created to try to evenly space out the material one hopes to review over the course of the time one has to study, factoring in days for practice tests and other days off here and there for personal matters as the student sees fit (within reason). It is very important to keep yourself in the full routine of USMLE studying, despite the odd circumstances. Don’t assume that you will remember everything that you studied and now you can take a month break while waiting for your new test date.

We like to compare USMLE studying to a bucket with holes in it. You study full time for 6-10 weeks filling up your bucket continuously then you take the exam while your bucket and knowledge is full. However, if you fall off into studying once every few days, studying casually for only 2 hours a day, or decide to just take a month off, the water will run out of your bucket and you will forget. Unfortunately, this means you need to keep at a schedule even without a definite end.

Essentially, students should plan as though nothing has changed in terms of your ultimate test date. If you have to push back your test date because of coronavirus, rely on your fundamental knowledge backbone though your Anki repetitions and the hard work you are currently putting in during a dedicated study period. Further, if you need a new and exciting study schedule to push you through this time, you can download one of our free sample schedules that utilize these concepts here (Step 1 10 week) or here (Step 1 6 week).

One final note about pushing back a test date or having to reschedule on own’s initiative once exam centers start to open up:

These strategies discussed above are designed to have you ready for your test date. Students often feel that as they get ready to ultimately take an examination, that they could use a few additional weeks to prepare. However, generally in our experience, students who continue to push back their test day tend to do worse than those who don’t. This suggests that at a certain point, the rate at which one is losing vital high yield information exceeds the rate at which one could be gaining information for test day, or essentially a point of diminishing returns. Therefore, try to take your examination around the target date you have set yourself (and if there are circumstances beyond your control, then rely on the fact that you will have continuous spaced repetition of your concepts through the methods we’ve outlined above).

We are currently living in highly uncertain times, and, in times like these, tried and true methods of
studying will be your best asset going forward. These include long-term memory consolidation with
spaced repetition, forming a daily study schedule and ultimately sticking to it. Our goal here at Elite
Medical Prep is to ensure that you are ready for test day, even in the most uncertain of times. With these recommendations, you can rest assured that you are putting your best foot forward when it comes to your USMLE examination plans. As always, if you need additional help or want to incorporate 1-on-1 tutoring into your study schedule, you can contact us here.