Top 6 tips for USMLE Step 1 Questions

Top 6 Approaches to USMLE Step 1 Questions

The USMLE Step 1 has many different types of questions, each with their own special strategy to find the best answer. However, there are six basic tips that can be applied to any USMLE Step 1 question.


  • Do Practice Questions

    This cannot be overstated. Your best preparation for Step 1 is to practice board-style questions. Start while you’re studying in M1 and M2 with review books that have Step 1 style questions and then utilize resources to practice review questions daily during your study period.

  • Read the Last Line First

    Most of the time, the question stems on Step 1 are very long but sometimes, the question they ask doesn’t rely on the information in the stem. For example, they may provide a long patient case only to ask “What’s the most common cause of hypertension?” for which you don’t need the patient information! This can be a time-saver.

  • Don’t Look at the Answer Choices

    Once you read the question, consider coming up with an answer in your head first and then find that answer among the given answer choices. This will help you go with your gut and keep you from choosing a “distractor.” Keep in mind that you may need to reformulate your answer to fit the answer choice. For example, you may be thinking “Vitamin C” but the answer choice may read “ascorbic acid.”

  • Use the Marking Tool

    If you find yourself spending more than a couple of minutes on one question, consider making an educated guess and marking the question to go back to it if you have time at the end. Because questions aren’t in order of difficulty, there may be easier questions at the end that you would have gotten had you not wasted time on a more difficult one earlier on in the block.

  • Don’t Change Your Answer

    Once you’ve thought through a question and selected an answer, avoid changing your answer. You will most likely change it to the wrong one! The exception? If you find new information in the question stem that changes your interpretation of the question, consider changing your answer.

  • Watch the Timer

    Have a method for monitoring your time. Perhaps you note when the time for a block is a couple of minutes short of half way and you check to be sure you’re just over half the questions. Whatever your method, be sure to have one. Even if time was never an issue before, it can be on this exam when you’re nervous or if you get particularly long question stems or complicated questions.