In this article, I am going to discuss about the best way to utilise your USMLE WORLD subscription for both USMLE step 1 and USMLE step 2 CK as the methodology to use USMLE WORLD is the same for both the exams.

There are few points that I need to stress importance on USMLE WORLD:

USMLE WORLD: It is a learning tool and NOT an assessment tool. The sooner you realise this, the better for you.
DO NOT SLEEP ON IT: It means when you are done reading it thoroughly, only then subscribe for it. Give your exam within 15 days of finishing it twice. It is considered as the final step of your preparation and not the initial step.
DO NOT PLAY WITH IT: It means, don’t just do the questions to look for their answers, do it in a timed mode, random and as close as possible in the exam environment.
DO NOT DO OFFLINE USMLE WORLD: Do not do offline UWorld just to get familiar with it. It will cause you more harm, do not join any group or page on facebook where they discuss USMLE WORLD questions, as you will know all the answers before hand and then, when you do your online UWorld, you will know the answers (the pool changes only 5-10%) and it will overestimate your performance.
DO NOT DO JUST THE QUESTIONS: Remember the learning points won’t be in the correct answer only. You will learn more from the explanations of the wrong options, so read the wrong options very thoroughly.

Do note the best iOS app for USMLE preparation – Dailyrounds.

Subscription for USMLE WORLD

There are some people who take six months subscription in the beginning of their preparation and they just do the USMLE WORLD on and off, by reading the texts along with USMLE WORLD. It may work for some people but I advise against it. I think the ideal time to take subscription, is when you are done with the reading part completely, when you think you are ready for doing the questions. By the end of the USMLE WORLD, you should give your exams at least twice within 15-20 days. The less you wait after you are done with USMLE WORLD, the better for you.
The subscription for two months is enough. Ideally, you should be able to complete the whole USMLE WORLD in 45 days and then use the remaining 15 days for its revision (second read).
When you pay for your subscription : usmleworld.com/sign_in.aspx, You will be able to download the software and you can log in the software with the same username and password as your login details on the main website.

USMLE WORLD Software

The main software is just like the real exam so the idea is not just to help you practice questions but also to help you familiarise yourself with the test environment. The dashboard will give you advantage of selecting questions from a particular subject and then, from a particular organ system. It will also give you the liberty of doing questions at timed/untimed mode, tutor mode, selecting only unused questions or only used ones. It also gives the numbers for total number of questions in the question bank, number of used questions, number of unused questions, number of correct answers and number of incorrect answers, number of omitted questions.
It selects questions for you and makes a block of 47-48 questions, to do at a time. After you are done with 2-3 blocks, it tells you your performance, the average performance of the people who are doing USMLE WORLD for the same sets of questions. It also gives you a graph that compares your performance to average performance, tells you your weakest and strongest subject and even how many times you changed your responses from incorrect to correct and then correct to incorrect.
During the questions, it lets you highlight things, strike out options, make notes, use calculator and access to normal lab values (just like the real exam).

Methodology to approach USMLE WORLD

• Although, it gives you much liberty to do questions in various modes, the best way to do the questions is, in TIMED and RANDOM mode. The reason for this is; some people prefer to do questions subject wise and I am not saying they don’t score high scores in the actual exam but my personal opinion is to solve questions randomly. When we do questions subject wise, our knowledge about the subject which we are reading these days is highest and also, every question you see is from a particular system (let’s say cardiology), so in a case you don’t even think about the respiratory cause of the disease in the differential because you are sure that you are doing cardiology questions only. Also, your mind is focused on a particular system during your subject wise questions. Another thing is that once you are done with one system (let’s say you did Kidney first), you won’t have any other questions from that system for about 30 days, which might make you forget things from kidney sections. Doing questions randomly not only broadens the horizon of your thought process while making differential, but it also helps you revise every single topic every day. Questions will be so random that you won’t be leaving any particular topic or subject behind.The timed mode is important because it’s not only about doing the questions right, it’s about doing them in the time allocated to you. When you do questions in untimed mode, your performance might be overstated because you are taking more time for the same question than others.
• Go slow, your aim should not be to do as many questions as possible in a day. You should be focusing more on how effectively and thoroughly you are reading the questions, and their explanations in a day. I advise you to start with one block per day in the beginning, wake up at around 7am and then start your fresh block at 8am (real exam time conditioning), complete it by 9am in a random timed mode. After 9am, your reading task starts, you should review your block now, read the first question and read it’s correct answer along with explanation of your wrong answer. For example, if you had a question on chest pain and your options were Gastroesophageal reflux disease (GERD), Myocardial infarction (MI), Pulmonary embolism (PE), Acute pulmonary edema (CHF), acute attack of Chronic obstructive pulmonary disease (COPD) and Lobar pneumonia (infection). Your first task is to jot down all the topics discussed in that particular question. Over here, there are six topics including GERD, MI, PE, CHF, COPD, Pneumonia. Then, go to the respective pages of these topics in your reading material and read about all these topics (presentation, causes, management and labs). In the beginning, it will take time, but, again, if in the next block (on your second day), you get a question about chest pain with the same options (but the correct answer would be different this time), then you don’t have to read everything again. This has been the best revision strategy so far for me. It’s a retrospective approach of studying your boring text material, where you are not just reading all the topics in a row again and again, you are also learning the practical aspect of the topic while reading about it. By this method, you will be revising your reading material along with USMLE WORLD.
• Once you start reading, you will notice that the topics have started to repeat in your questions and that will help you in spending less time to review your reading material and you will realize that you will have more time left in a day (after about 10-15 days of USMLE WORLD). Increase the number of blocks per day, such that, do one block in the morning, read all the explanations and reading material (of new topics only) and then, do one more block in the evening and read half of its explanation. In this way, you would be doing three blocks in a span of two days. The more confident you get, the more blocks you can do per day but never exceed it above two blocks per day. A thorough read is what you need for the topics per block. Tip: When you start doing USMLE world, don’t get involved in any other thing. Devote most of the day to it.
• Whenever you are reading explanations for your questions, always highlight things which you think would be needed later on, so that when you revise, your USMLE WORLD the second time, you will only look through the highlighted material. Also, while reading your explanations make notes out of it in a word file/note book which ever you are comfortable with. In the end, this would be the best revision material for you.
• Also, if during reading your material, you come across any ECG, X ray, MRI, CT, heart sound, lung sound, any clinical sign (christmas tree rash, herald rash, shagreen patch, gottron’s papules, heliotrope rash, boutonniere deformity, erlenmeyer flask deformity, hemiplegic gait), then GOOGLE those images and watch youtube videos about it. Make a folder in which you can collect all these googled information with pictures and videos. It will be very useful to have a final look at them (specifically for dermatology).
• After 45 days, you should be done with the entire USMLE WORLD along with its explanation. You will have a complete set of notes out of it and you will realize that you would be done revising the entire reading material more than once. At this point, your average should be in 70s (>250 in USMLE). Give an assessment exam like NBME or UWSA. After doing that assessment exam, if your score was in 250s or even in 240s, then you are good to go. Make a final judgement from your USMLE WORLD performance stat, as to which subject/topic is your weakest and try to read that from your reading material again.
• The last 15 days is your second USMLE WORLD read of explanation. It is enough time for your second read as your won’t be reviewing your reading material this time and you will just be going through the blocks. My advice to you is to go through all the blocks and all the questions (not only the wrong ones), this time it will be worth it.
• After your second read, give another assessment exam. These assessment exams are pretty standard, they closely correspond to your real USMLE score. If you are getting 250s in these exams, DO NOT WAIT for anything, just go and give your exam. You will never feel prepared and confident for USMLEs, just go and get over with it.
• Sometimes people don’t get what they expect; if you are getting 240s in assessment exams, but you aimed for 260s, then, even with one more month of preparation, you will get the same score in those assessment exams. They are pretty standard and if you are getting same scores in them, it means there is nothing you can do now. You have reached your peak capability. The bitter truth is, you should also give the exam as early as possible, as with time, it is only going to get worse.
• In the last 2-4 days, you should read the notes that you made from USMLE WORLD and it will be a quick recap of everything you did in the last 2 months. You can review those googled images that you saved in that folder and go through some youtube videos.

Two months not enough

Sometimes, because of unavoidable circumstances, you get distracted during your USMLE WORLD reading days. If you are not able to finish the two reads of the USMLE WORLD, then don’t rush things, just extend your subscription, there is nothing more important than your preparation. There are no fixed rules and you should judge your preparation level by yourself. You can give consume as much time as you want, if you are actively making use of the USMLE WORLD.

Also read,

Six things you can do in college before USMLE step 1 preparation

The best iOS app for USMLE preparation – Dailyrounds.

Top 10 medical apps for doctors in Google playstore.

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