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How Do I Use UWorld?

Activity Forums USMLE Step 1 Forum How Do I Use UWorld?

This topic contains 4 replies, has 4 voices, and was last updated by Dr. David Delnegro MST USMLE Tutor Dr. David Delnegro MST USMLE Tutor 4 months, 1 week ago.

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    Almost everyone who takes USMLE Step 1 has heard the advice: “Make sure you get through all of UWorld.” It’s a common refrain, and UWorld has become something of a necessity in preparing for the USMLE exams over the years. Truthfully, with good reason. UWorld is by far the most important resource you can use in preparing for the USMLEs.

    In spite of being such a universally used resource, there are many (equally correct!) ways to use UWorld. Your circumstances will dictate the best way to study, but there are a few universal principles I like to apply to starting.

    Simulate the real exam from Day 1
    Take at least twice as long to review the answers as you do to answer the questions
    Plan for a block a day to schedule how long you need to complete UW

    Simulate the Real Exam

    It can be very tempting to do questions on Tutor Mode, to review questions in topics you recently studied, and to not stress yourself with the timing of the exam. Sometimes, that can be useful. I have found, though, with many of my students, they then experience a significant fall in their UWorld scores when they start to prepare for the real exam with the “full” UWorld experience with all subjects and full timing. Besides the effect this inevitably has on morale and confidence, this often leads to wasting time reviewing old topics again, when the key to studying is spaced integration from the beginning. I always recommend beginning with 40 question blocks, all subjects, all categories, and timed.

    Twice as Long to Review

    As most tutors will tell you, the real value of UWorld lies in the answer explanations and thought processes. It often takes my students 2-3 hours to get through the explanations for a forty question block, because it involves more than just reading through the text. From the answers and explanations that you get right OR wrong, everything should be reviewed. For some students, that means annotating into First Aid so you have a consolidated resource. For others, that meant making Anki cards. Then, with the rest of your day, when you are reviewing FA or doing your Anki, you will continue to review those concepts throughout.


    Given the volume of questions, typically students will need to start between two to three months prior to their exam date. UWorld has approximately 2400 Step 1 questions. Thats 40 questions/day for 60 days. Add into that the days you will take to do NBME practice tests, breaks, and a second pass, and you can easily see how this turns into three months. A lot of students have said to me “I’ll just do four blocks a day to make sure I get through it,” and they almost always end up burning out, or skimming through the explanations (which, as I mentioned above, is one of the most important parts of “doing” UWorld. Make sure you plan for more time than you’ll really need.

    Dan S., MST USMLE Tutor
    Reputation: 29
    USMLE ExpertMD or DO

    Extremely well explained. I am with you on the “Simulate the Real Exam” front. An added bonus of this approach is that tracking your performance on these blocks over the course of weeks or months can be a pretty good metric of progress and can really help identify trouble areas. This way, if 2 weeks into studying you are finding that when cardiology questions come up, you are still struggling with them despite having done an FA cardiology 1st pass, you can re-target that area. That’s a lot more helpful than reading FA cardiology, then doing well on a few sets of FA cardiology questions, and then thinking you are in good shape and not seeing a cardiology question again until weeks later only to find that your really struggling with them and you’re running out of study time.

    Dan S., MST USMLE Tutor
    Reputation: 29
    USMLE ExpertMD or DO

    I’m not sure I totally understand. Is the question: once you have annotated a chapter, when you cycle back to review that chapter, should you just read your annotations or both the original content and your annotations?

    If so, here is my take: After a first pass through all of the FA material, each subsequent pass should be increasingly focused on the areas you are struggling with, and should be increasingly geared towards “studying” rather than “reading”. What I mean by this is, if you are doing questions daily, by the time you get back to the endocrine chapter in a week or two, you should have a good sense of which pieces you are getting wrong in questions and which pieces you have a good handle on. It is okay to skim over the areas you feel good about, and dive into the areas that are giving you trouble, doing flashcards, quizzing yourself, doing focused question sets, etc. to hammer those pieces home. For those problem areas, it will definitely be worth spending time on both the original content and your annotations. For the other areas, using your annotations to remind you about aspects of the original content might be sufficient. Try to be honest with yourself about how comfortable you are with each piece of the material.

    Please let us know if this doesn’t answer your question!

    Reputation: 13


    I am an IMG. I have completed my first reading of Endocrine in FA and have completed the UWorld for the Endocrine chapter. I am currently receiving 40% on my UWorld scores, which is okay because it is a learning tool. I have annotated the Educational Objectives from UWorld into FA. My question is that when I go on to the next chapter which is GI, how do I complete the Endocrine that I have previously completed? Do I re-read the notes that I have made in my FA or do I re-read the whole chapter with the annotations. I am really confused on this. And when later chapters add up, how can I fit all the reading into it? Hope this is understandable. Thanks.

    Also, I need help making a study schedule and I would like a tutor to help me with this too


    I typically tell students to approach studying in an n+1 approach. In the evening, review the notes you made today and the notes from yesterday. What you understand you can leave be moving forward. So, for your first day of GI you would review that material alongside your notes for the last day of endo. What you understand, move on. However, if you still have an unresolved endo weakness, spend a few minutes approaching it and add it to the next days queue as well. Often a new resource or different angle will help it fit a little better this time around.

    Rinse and repeat.

    And reach out to us so that we can help you put together a schedule and help you 🙂

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