Step 1: One more point.

Ryan, MD/MA Bioethics Student

May is that time where everyone is furiously studying…except for the seniors…  Of note is the proximity of USMLE Step 1, arguably the single most important test in medical education.  For those unfamiliar with USMLE, Step 1 is one of three all-day written exams necessary for licensure in the US.  Step 1 covers comprehensive basic sciences, and is taken at the end of sophomore year.  So for those who are studying for Step 1 or any other exam in any other school, I’d like to offer a bit of encouragement in the form of a personal story.

First, the moral:  every bit of studying counts.

Some of the more competitive residency programs have a threshold Step 1 score (this is a screening method, because they’re competitive and they can).  This threshold varies between institutions.  In researching orthopedic residencies, I recently found out that I’m one point shy.  Just one point too low to even apply to a few certain residency programs.  Sure, I can apply to many others, but it hurts to feel excluded like that, knowing that it’s only my fault.  But would studying a bit more have even made a difference?  In my case, yes.
Step 1 doesn’t have a one-to-one correlation between points and questions, but it’s very close.  There was one fact that I had memorized wrong during that unit in lecture, and I kept getting it incorrect on my USMLE World question bank.  I just didn’t restudy it with enough focus.  Low and behold, that same question (nearly verbatim) showed up on Step 1.  Go figure, I got it incorrect.  What bad luck.  It was the one question I looked up when I got home (don’t do that, by the way).  In the words of my hockey coach when I messed up, “You just didn’t want it bad enough, huh?”  It’s not that I didn’t want it.  I just didn’t do it.
Many people get the post-test regrets of “I wish I had studied just a bit more.”  Instead of a vague feeling, I have a discrete example of why that’s true.  I hope this little anecdote isn’t discouraging (as it was to me as I experienced it).  It would be easy to say “I’m going to make mistakes no matter how much I study,” or “comprehensive over two years? or “last-minute studying will make a difference.”  And I can’t stop you from drawing that conclusion.  In this case, Dr. Werner was correct:  you’re just as likely to get a question from the last lecture of sophomore year as from the first lecture of freshman year.  However, the point of this story is to give you that extra push, that resolution to keep at it when you’re already exhausted.
So keep studying, because every point matters.  Hopefully you won’t learn that the hard way.