Strategies for answering USMLE and other medical board exams. 

• Study common disease conditions, as this is likely to be the majority content in the board exams. Don’t spend too much time studying rare diseases and syndromes.

• Cheap is good: For exam purposes, try to choose the least expensive test, and the least invasive procedure.

• USMLE Step 1 exam is usually fact based. USMLE Step 2 exam usually tests your ability to make diagnosis by synthesis of medical facts and lab data. USMLE Step 3 and Internal medicine boards usually test your ability at clinical decision-making and medical management. The medical diagnosis is either given or implied in the question.

• Focus on the lead line: The lead line of a question is usually very specific about the information asked and gives a clue to the testing objective of the question.

• Asymptomatic patients: If the question talks about an asymptomatic, otherwise healthy patient whose “medical condition” was found only by accident or at a routine physical, the answer is usually “observation” or “do nothing now”. The testing objective here is to make sure you don’t consider medical interventions where none is needed. However, keep in mind that this may not be true for all the questions and the answer depends on the patients specific “medical condition”

• Technical mistakes: The following are some “technical mistakes” that question writers make and may give clues to the correct answer. These have been systematically removed from the board exam question banks. So, don’t rely on them to help you guess the correct answer. 

ü The correct answer is much longer than the other choices given.

ü Grammatical mistakes…if the last word of the lead line of the question is “an”, you would infer the first letter of the correct choice would be an vowel (a, e, i, o, u)

ü Two of the choices basically say the same thing: Then both may be false choices (both cannot be the correct answer).

ü Two choices say the opposite thing: Then one of them may be the correct answer.

·         Guessing: if you have no idea what the answer is, pick one answer (guess) and move on. There is no point wasting too much time on one particular question. This is especially true when answering medical statistics questions.

·         Time management: Most USMLE exam takers have a problem with finishing the test in time. It is important to realize that you cannot get all the questions correct. Besides, you don’t have to get all questions correct to get a good score. So plan your exam strategy wisely and try to finish in time. 

·         Think backwards: If you have no clue what the correct answer is, try to think backwards. Read the lead line and stem of the question once more and try to guess what the testing objective of the question is. Then pick the choice that corresponds to this testing objective. 

·         Avoid choosing answers with absolute words like “always, never”, etc.

·         If “all of the above” is one of the options, and you are trying to guess, pick it.