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USMLE Exam Experience – Handling the Day of the Exam!

The USMLE exams are probably one of the longest and the scariest devils that you will ever face as a doctor. These exams can be your greatest achievement leading to a fruitful career, if handled with a cool mind and the right attitude. I am sharing my USMLE Exam Experience in order to help people reach their goals.

Medicine is 20 percent intelligence and 80 percent hard work. Interestingly this ratio shifts to the opposite in case of the USMLE’s. Every candidate has been reading the same materials and solving the same question banks over the years. Why is it that the results have varied so much?

Strong focus and self-control will help you hit the bull's eye!

Strong focus and Self-Control will help you hit the bull’s eye!

The answer to this question lies in the fact that every individual responds differently to stress. Some live up to the challenge, while others suffer due to their own fears! Here is a recollection of all the factors that I felt would have helped me taking the tests better. I must emphasize that these are my experiences from my own personal mistakes, the motive is to help my peers avoid the same.

Day before the exam

This day should be spent calmly revising what you have already learnt. This day is not meant for reading the most complex topic that you have been avoiding during the prep.

  • If your test is in a city different from home, invest in a hotel and avoid traveling on the day before the exam.
  • Lightly read all your hand written notes. Stick to review materials rather than textbooks.
  • Spend an hour arranging your bag for the battle next day. Keep your ID, your Scheduling Permit and research the traveling distance and traffic situation.
  • Shop for a variety of food items. This is not the time to count calories. Buy what you fancy; it can be a box of chocolates or a bag of crisps. Make sure there is a combination of salty & sweet, and solid & beverages.
  • Sleep for at least 8 hours, else you will feel your eyes close 2-3 blocks into the exam. I had the misfortune of sleeping at 0400 AM before my Step 1. Not Recommended.

The Dreaded Morning

The day has arrived. You have woken up for one of the most important days of your life.

  • Take a relaxing shower. It will help with the nerves.
  • Have a reasonable breakfast. Do not indulge in a heavy pancake and maple syrup sort of a meal.
  • Pray to whichever deity that you believe in. It will help calm you down. Helped me immensely.
  • Start early for the test center. Leave little for luck.

Getting Ready

  • Wear loose fitting comfortable clothes. Do take a thin jacket of sweatshirt with you regardless of your geographical region. Prometric maintains a steady temperature using air conditioning. You might not be used to it.
  • Check your essentials. This is not limited to your ID and Scheduling permit. I had the misfortune of forgetting my glasses for my Step 2 CK and squinted throughout the exam.
  • Keep medicines for the basic calamities. I suggest diarrhea, headaches and cramps.

The Journey

While travelling to the test center, think of positive thoughts. Anticipate the exam rather than fear it.

  • Do not read on the journey, many people complain of having headaches while reading on the move.
  • If you leave on time you will reach on time. As simple as that.

At the Test Center

  • Be courteous to the staff. They are there to help and to make sure the exam is fair and square. Cooperate with them.
  • Feel free to make chitchat with fellow examinees while waiting outside. You will feel relaxed. I am still in touch with a person I met during my exam. We have been sharing inputs about our progress regularly.
  • Once you are inside, avoid talking to anyone unless it is a member of staff.

The First 20 Minutes

“The first 20 minutes of the exam are the most crucial”. You will agree with my statement the moment you are done with your exam.

The first 20 minutes can be crucial and should be handled with peace and calm.

The first 20 minutes can be crucial and should be handled with peace and calm!

  • TAKE the tutorial. At least for the part where your speakers are tested. Familiarize yourself with the system. There are subtle differences between the question banks and the actual software.

You have entered the exam to excel. You have subconsciously ridiculed the people who have scored less than “your projected score”. In your mind you can easily score the 240 that your friend had, you are here for the 265+ feat. Be prepared for a nasty surprise!

You will probably struggle to find an answer to the first set of questions. 7/10 of the times you will be making an educated guess. DO NOT PANIC! This has happened to everyone and you are no different!

  • Once you are past this surprise stage, the exam will start to make sense. Your mind will adapt and you will be in flow soon. Be patient for that to happen.

Taking the Breaks

  • In my personal opinion, never do 2 blocks in a row. I took at least 5 minutes after every block.
  • My routine was- Come out; have a drink & a quick snack. Visit the loo and get back on the game.
  • In the almost 30-35 blocks that I have faced, I have never done 2 in a row and I stand by my decision. This definitely works. Your mind is refreshed and you function better.
  • While on a break, do not overthink about your performance in the previous blocks. Think ahead and relax.
    Think ahead and relax!

    Think ahead and relax!


  • You may be used to sitting for hours at your own desk, sipping your favorite drink. Remember- the test center will be different.
  • Before the exam, go to your local library.
  • Choose a computer with a basic square screen. 14 inches in size. It is very important that It has a clickety clackety keyboard.
  • Take a pair of generic headphones, the cheap ones that make a constant buzzing on your ears.
  • Sit next to a person who types noisily and makes loud Mmm’s and Aah’s. Remember prometric hosts a variety of exams, and there is a possibility that there will be a person sitting next to you giving a written exam/ spoken exam. This happened to me in my Step 2.
  • Now try and concentrate for 1 hour straight and then take a 5-minute break.
  • Repeat this process till you can concentrate, and you will be ready for the Exam!

Hope sharing these experiences makes a positive impact on your exam. All the best!!

Dr.Harpreet Singh MD, FACP is a Chief Executive Officer and Founder of Vital Checklist and The text, graphics, images, videos and other material contained in the videos and iCrush Website ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Dr Ankur Sinha - Executive Editor
Dr Ankur Sinha is a budding physician. He is an avid researcher and finds solace after his hours at work, in putting his thoughts into words. He advocates upheaval of set practices and blind notions using science and research. He strongly believes that " When you work for your passion, your life becomes an endless vacation"

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