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Understanding the Three Phases of USMLE Prep

Understand the Three Phases of USMLE Prep

Hey There, Mike here again. Lol.

Hope you are learning a lot about how to tackle the USMLE Step 1. Today, we will talk more about the three phases of USMLE prep.

The Three Phases of USMLE Prep

Actually I coined the term three phases of USMLE prep way back on 2006. I needed a framework to explain to people what steps they needed to go through to get from not knowing anything, to knowing something so well that they could answer USMLE type questions and score really well.

We actually all go through these three phases in varying degrees when we were studying in medical school. However, I noticed that during USMLE prep, people tend to skip some parts of the process and therefore get into trouble later in their prep.

In brief the three phases are learning phase, mastery phase and test preparation phase. You need to learn something first if you don't know it. Learning requires understanding primarily and memorizing enough facts to support that understanding. Unless the exam tests only for pure recall of facts (which the USMLE does not) then you need to truly understand the concepts not just memorize them.

After you have learned something, you need to memorize all the facts so you can answer questions about it or discuss it. Unless the exam is open book (which the USMLE is not) you need to have all the facts in the head. The worse thing that could happen is understanding the question, but lacking the fact needed to tie everything together to answer the question correctly. This is one of the most common complaint when people start doing online qbanks. "I understand the topic the question is asking about, but I still can't answer it." is a very common complaint.

The test preparation phase is usually skipped by most students since they are usually used to taking short exams and are familiar with the different types of questions in an exam. However, some students do take practice exams when they do shelf exams or other shorter exam. However, for longer exams having a formal test preparation phase can make a very big difference in your final scores. This is especially true of the USMLE.

Nothing is particularly hard if you divide them into smaller jobs.

Henry Ford
Founder, Ford Motors

Why Three Phases for USMLE Prep

As I said everyone goes through each phase at varying degrees even during medical school. But in a very long and very tough exam like the USMLE, it pays to separate the three phases for better prep.

First, Study materials used for each phase is basically different. You need textbooks and basic science lectures in order to learn and understand medical concepts. You need lots of explanations and examples in order to understand what you do not know.

However, for the mastery phase, you need to memorize all the stuff. In an exam as big and tough as the USMLE, memorizing textbooks will be impossible. So you need to use reviewers, which are in the form of bulleted lists, tables and illustrations/diagrams. Why? Because they are easier to memorize and fill up less memory space.

For example, the best way to memorize the coagulation cascade is to use a diagram of the coagulation cascade, and maybe a table to summarize some details of each of the process. However, for someone who does not know the coagulation cascade, the diagram would be impossible to understand. He would need about 5 pages of explanatory text and in some cases a professor to coach him so that it will make sense.

Again, memorizing 5 pages of explanatory texts will take up too much time and fill up memory space fast. Plus recall time will be slow because it takes longer to recall 5 pages of explanatory text compared to a one page diagram. We tend to find it easier to recall information sequentially in the order we learned and memorize it, than randomly. Hence, memorizing blocks of text means we need to recall then in blocks of text maybe even pages before we get the exact information we need.

Back when Kaplan was still offering its IV or integrated vignette qbank, people observed that they tend to score up to 10 percentage point higher in the IV qbank than in the regular qbank. The IV qbank groups from 3 to 5 questions related to single topic together and asked them in sequence. The 10 percentage point advantage is due to being able to recall information sequentially. Since you tend to recall related information together, you actually find it easier to answer related questions after each other.

However, the USMLE requires you to recall information in a random way. That takes more time to do and makes recall harder. That is why it is important to practice random recall as part of your mastery phase. That is accomplished by using properly designed flashcards and always answering your qbank practice, timed, random and fresh.

Memorizing information in a compact form can help you retain more information and recall them much faster during the examination. Something to think about.

Second, rate of learning is very variable and very hard to estimate how long it will take to learn all the topics you need to know. Mastering and memorizing information is much more predictable and can be finished in 2 to 6 months at most.

Third, it is easier to pinpoint where your prep went wrong by segmenting it into three phases. Usually by the time you are practicing online q banks and doing poorly, you need to identify what you did wrong in your prep. If you are having a hard time understanding the question or the answer the question want, then you have problems in the learning phase. Ditto if you have no idea what topic the question is asking for.

If you understand the questions and know what the topic is all about , but find it really hard to find the right answer or even narrowing down the choices, then most probably your problem is either in the mastery phase or test preparation phase. In order to distinguish between the two, you need to look at the correct answer. If once you know the answer, it suddenly dawns on you why it's the correct answer without having to look at the explanations, then you have a mastery phase problem. If you needed to look at the explanations to answer, then you have a test preparation phase problem.

Anyway, the above is just a rough guide so it may not always be the case. If you want to know more details on how to pinpoint where your prep went wrong and how to fix them, refer either to my book or the online seminar workshop. Or better yet learn more about how to implement them in detail before you start your prep so you prep right the first time around right from the start.

Make sure you have all three phases accounted for in your study plan.


P.S. Next issue we will talk about "Why Failure is Not an Option for the IMG." Although 30-40% of IMGs fail the USMLE Step 1, there is actually no reasonable excuse why IMGs should ever fail Step 1 except for carelessness, arrogance or stupidity. Even old IMGs. And I will tell you why next issue.

Better Prep.

Easier Exam.

Higher Scores.

How to Master the USMLE Step 1 Book

Better Prep.

Easier Exam.

Higher Scores.

How to Master the USMLE Step 1 Seminar

Score HIgher. Read the Book.

An in-depth written guide on how to prep better and score higher for the USMLE Step 1. Read the book. Better Prep. Easier Exam. Higher Scores,

Score Higher. Listen to the Lecture

A 48-module lecture seminar on how to prep better and score higher for the USMLE Step 1. Listen to the Lecture. Better Prep. Easier Exam. Higher Scores.