The Key to Acing the USMLE Step 1

By askdoc / May 29, 2015
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key to acing the usmle

The Key to Acing the USMLE Step 1

Acing the USMLE Step 1 (and Step 2 CK)

When I started thinking about taking on the USMLE way back in last quarter of 2004, I would scour through all the forums. Trying to find any information I can get on how to tackle this difficult exam. I would pay special attention to the postings on exam experience. And whenever I see someone posting that they got a 99, I will read it avidly, desperate to find out how it is done and wishing that it was me. Like most of you I was desperately looking for the key, not just to passing this exam, but acing it.

However, it wasn’t long before I notice that everyone was reviewing the same materials. Kaplan notes, FA, Kaplan and UW Qbank, Goljan notes and yet the results range from failing to high 99’s. So it wasn’t the materials that they were using that is the key to scoring 99 although it makes sense that they should be important.

It also seems that most people who studied those materials were at least passing the exams, but very few were acing it. So it seems using the right materials will help you pass the exam, but not ace it. You need something more than that.

So I did my own research on what it would take to get a high score. I went through various study materials available. I devised specific approach to each study material to maximize my ability to retain and recall the information in them. I tried to apply what I know about good study methods for maximum retention and recall.

I also research everything I can on the USMLE questions themselves. What makes them hard? What makes the whole exam hard? I figure out how to train myself so I can function at the level needed to beat this exam.

And so I did. I took my USMLE Step 1 Examination in April 2006 and scored a 99/256. I took my USMLE Step 2 CK in November, 2006 and scored a 99/258. So I finally made it. All that hard work and I aced both exam.

ace exam

It’s not luck to ace the exam!

Is There Really a Key to Acing the USMLE?

I had written extensively of how I did my review in the forums, especially at And a lot of people have sought my advice. Although not everyone got a 99 there were a few who told me that they got a 99 by following my advice. A lot of people wanted to know how I did it. They wanted to know the key to acing the USMLE.

My initial thought was, there was none. I had done so many things in order to ace the USMLE, that it was impossible for me to reduce the whole process to one key thing I did. I studied and mastered the basic and clinical medical science subject tested in the exam. I had mastered the exam questions themselves, training myself how to tackle those questions. I had done specific training so I can answer questions very fast and yet still get the correct answer. I had trained myself to be able to retain a lot of information and recall them fast with a snap of a finger. I had trained myself to be able to perform at peak performance even when I am tired and my brain is telling me to stop it. (At this point, my training kicked in and I was still getting the right answers, because I trained my mind and body to do it.) I had to train myself really hard in order to be able to do this right.

Geniuses Have No Problem Acing the USMLE

Then I thought about those geniuses. You know them. They don’t really spend so much time studying and yet they seem to have no problem acing the USMLE. In fact, they make it look so easy, that when some non-geniuses stupidly tried to follow the way they study, they wind up failing miserably. So how do they do it?

We all know that it is easy to score high or ace the exam if it is easy. In fact the easier the exam, the higher the scores, the harder the exam the lower the scores. So if the USMLE is a hard exam, how do geniuses ace them? Could it be that for geniuses, (music please) the USMLE is easy? You bet your life it is.

Acing the USMLE is easy for geniuses. In fact, about 15% of all examines who take the USMLE actually ace it. Since the minimum IQ of doctors is 120 and the average is 135. The top 15% of all physicians means they are all probably geniuses. So the key in acing the USMLE lies with those geniuses, and somehow I was able to do the same thing. So how does a non-genius like you and me ace this exam?

The answer is do it the way those geniuses did. For those geniuses, the USMLE Step 1 (and Step 2) is easy. Therefore, if you want to ace the USMLE, then you need to do it their way, that is, make the USMLE Step 1 easy for you.

At this point, some of you have a glint in your eye because you got what I mean. Another group will have question marks on top of their head as they wonder, “What the heck is he talking about?” Meanwhile a third group will have skull-bones and lightning blazing across their forehead. Didn’t you just say not to do what the genius did or we will fail miserably?

Actually, I did not say not to do what they did. What I said is not to study the way they did or you will fail miserably.

Isn’t that the same thing?

No, it’s not. I will explain it in a little while.

I will say it again, the key to acing the USMLE is to make it EASY. That is how geniuses do it. That is how I did it and that is how you can do it. Do it like those geniuses did.

We Have Met the Enemy, and He is Us.


I will tell you two stories one involving a mountain, another involving a video, that hopefully will illustrate the key principle to excel at anything not just the USMLE. You may find parallel situations in your life that hopefully will lead you to understand that you too can ace the USMLE and the only one preventing you from doing so is yourself.

ace exam mountain

Climbing a mountain is easy, if you know how.

How Hard is it to Climb a Mountain

First, the mountain. A few years back, I decided to climb Mt. Pulag, the second highest peak in my home country with an elevation of 2922 meters. It is considered a tough mountain to climb. It is often used by the military for altitude training and not everyone pass the course. Anyway a group of us decided to climb it with a guide. Starting from the rangers camp at the foot of the mountain, it was about 2 km to base camp 2 and although tired we were elated that we reached our first milestone.

It’s another 2 kilometers to reach base camp 1 where we will spend the night before climbing up the summit the next day. As we started our way to base camp 1, it became apparent that it was not going to be as easy as the first leg of our journey. We were thoroughly exhausted after the first leg and after an hour we were all asking our guide how much farther. The guide answered 10 to 15 minutes. We all laughed thinking he was joking. Anyway, we started moving again and after half an hour, some were too exhausted to move. The guide called a stop and told us that we were dehydrated and need to drink more water. Most of us showed him our empty water bottles. He decided to take our empty bottle and refill it in base camp 1 before bringing it back. We asked how much farther, again he said about 10 minutes and left us on the trail. Nobody laughed this time and one of my companions mumbled ‘he’s kidding, right’.

It turns out our guide was not kidding. 15 minutes later our guide was back from base camp 1 with the refilled water bottles. It took the rest of us another 1 and 1/2 hour before we reach base camp 1. So for him it was really 10 minutes. When I asked him later how long it takes him to go from base camp 2 to base camp 1. He said about half an hour. He laughed and told me not to worry. Most people take about three hours and even well-trained soldiers take about an hour to an hour and a half.

So for our guide that mountain is easy. But for the rest of us and most of humanity out there, it’s hard. And yet it’s the same mountain. So how hard it is to climb a mountain does not depend on the mountain, but on the person climbing it.

ace exam abs

How easy or hard it is to get a six-pack depends on the person.

How Hard is it to Get Abs and Six-Pack

Now the video. How many of you have heard of the P90 or Power 90 exercise video by fitness guru, Tony Horton? P90 promises to give you an incredibly ripped and muscled body in 90 days so long as you follow the video. I thought it was another one of those infomercials that was all hype and no substance. That is until I saw the video. Then I realized that they were right. If you are able to do what they are telling you to do on the video, you will get that body in 90 days.

But you know there is always a catch. And the catch is, can you do it? Watching the video, you know most people won’t be able to do it. Either they will find it too hard or some other reason for not being able to do it and thus fail. But if you are able to do what it asks, it’s almost sure that you will get that well-toned body.

One more thing, Tony Horton and his students make performing those exercise so easy, that you feel like you can do it, too. That is until you tried it. Then, after sore muscles and stiff joint convinces you otherwise, you know it’s not as easy as it looks. Yet they make it look so easy.

Most people’s initial reaction including mine is that they are fit, that is why those exercise routines are easy for them. They all have ripped bodies, abs and six-packs. But it also dawned on me if I get to the point where those same exercises will be easy for me, then I will have ripped muscles, abs and six-packs. So 90 days later, after lots of pain and just plain hard work. P90 was now easy for me. And I do have ripped muscles, abs and six-pack. My body went for B-shaped to V-shaped. Hehe.

So it is possible to make what was once hard for you, become easy for you if you are willing to put in the hard work to make it easy. So climbing a mountain and doing an exercise video is the same. What determines how hard something is does not depend on the thing but on the person doing it. Whether something is hard or easy for you depends on you. You can make what is hard for you easy, if you are willing to do the work to make it easy.

So that is the secret to scoring high or even acing the USMLE Step 1. To score high and ace this exam, you need to make the USMLE Step 1 easy. For most people taking the USMLE Step 1 it is a hard exam. Just like Mount Pulag is a hard mountain to climb for most people. But if you are well-prepared and trained properly for this exam (or a genius), then it becomes easy, just as climbing Mount Pulag was easy for our guide.

And so that is what I did. I trained myself and prepped for the USMLE so it became easy for me. The easier the exam, the easier to get a high score. The harder the exam, the harder to get a high score. And that is the secret. How hard or easy the exam eventually become does not depend on the exam itself. It depends on the person taking the exam. The better trained and better prepared you are for the exam, the easier it becomes.

askdoc usmle ace

Make the USMLE Step 1 Easy and You will Ace It.

Learn How to Make the USMLE Step 1 Easy and Ace It.

So can you learn to do what I have done, make the USMLE Step 1 easy and ace this exam? You bet you can. Remember, the goal is to make the USMLE Step 1 easy, not to make the prep easy. In fact, most of the time, you need to prep harder to make the USMLE Step 1 easy. And the easier your prep, the harder the exam will turn out to be. So if you want to make the USMLE Step 1 easy, be prepared to prep hard. Don’t be like a lot of people looking for an easy prep. The exam will turn out to be really hard for them. So don’t follow them

As I write this, I just received an email from one of my students, who sat for the USMLE Step 1 last April 29, 2015. Dora is an old IMG student of mine the past year. She just aced USMLE Step 1 with a score of 254. Just two points short of mine. Here’s a quote from her email.

“Dr Mike,

your system NEVER fails. I passed with a personal score of 254!!!!!!!

thank you, thank you, thank you “

So let’s start on our journey to acing the USMLE Step 1. I have divided the whole discussion into the following sections. As articles are posted on the blog, the link will turn blue. You may want to subscribe to our email list if you want to be informed by email once new articles are posted. I will just write a brief description of each topic and discuss them in detail in future posts.

  1. Why You Need to Make the USMLE Step 1 Easy. The USMLE has a mandate to make sure 90% of AMGs should pass Step 1, so there is a limit to how hard they can make it to pass Step 1. But there is no mandate on how many should ace this exam, so there is no limit to how hard it is to ace Step 1. You need to know all the reasons why it’s hard to ace Step 1 so you know how to overcome it. It’s many times harder than just passing it.
  2. How to Make the USMLE Step 1 Easy. You need to make the USMLE Step 1 easy for you, so you can ace it come exam time. It will require you to have certain knowledge and skills that you won’t need if you just want to master Step 1 and pass it. It will require a lot of additional work to acquire these knowledge and skills except if you are a genius. But if you are a genius, then there is no need for you to read this to ace this exam. You most probably already have those skills and knowledge and can do it on your own.
  3. Creating a Study Plan for Acing the USMLE Step 1. You need to create a study plan that will help you make the USMLE Step 1 easy for you. A standard study plan for mastering the USMLE will not do. There is a lot more things you need to do and. A lot more preparation than just passing the USMLE. You don’t only need to prep harder, you also need to acquire skills that you don’t need if you just want to pass this exam.
  4. Learning Phase to Make the USMLE Step 1 Easy. Unlike mastering Step 1, a formal learning phase is a must if you really want to ace Step 1. There is no room for weak points. You need to make sure you have covered every little bit of medical knowledge that may come out in the exam.
  5. Mastery Phase to Make the USMLE Step 1 Easy. The mastery phase for acing the USMLE is slightly different from just mastering step 1. There are a lot more things you need to do in order to make sure the USMLE Step 1 is easy for you come exam day.
  6. Test Preparation Phase to Make the USMLE Step 1 Easy. You need superb test-taking skills if you want to ace it. Since this is a skill, it is not enough to know them, you need to practice and practice until it is second nature to you.
  7. Sitting for the USMLE Step 1 and Acing It. In the end, the only thing that matters to the USMLE is what happens on the day of the exam. You need to be in tip-top shape on the day of the exam. You need the USMLE Step 1 to be easy for you on exam day, so you can ace it.

You need to read the sections on “Mastering the USMLE Step 1.” Those articles discusses how to pass Step 1. The discussion here will be what you need to do beyond just mastering Step 1. So you can make it easy. So you can ace it.


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