What Are the Hardest USMLE Topics to Study and Learn?

USMLE Step 2 Test Prep

The United States Medical Licensing Exam, known as the USMLE or simply “board exam,” is by far one of the most difficult examinations in existence today. It covers several years’ worth of highly complex information that you must know in order to become licensed in your field. The following USMLE topics are widely regarded as the most difficult, so familiarize yourself with them early on and perhaps give them some special attention, too. 

Biochemistry 

Biochemistry is truly a paradox among medical students. It’s absolutely fascinating to explore the various chemical processes that keep human beings alive, but as part of gaining a firm understanding of the subject, there’s a lot – a lot – of memorization involved. You’ll find yourself learning about metabolic pathways, enzyme design and structure, and much, much more, so without a solid understanding of terms and their meanings, it’s difficult to understand much of anything. The sheer complexity of biochemistry makes it the most difficult topic on the USMLE according to the majority of medical students. 

Many doctors (who were once in your shoes) recommend that you take the time to study up on the basics of biochemistry whenever you have a chance. Simply understanding basic terms and processes will make everything to come much simpler for you. 

Microbiology

Medical students also agree that microbiology is the second most difficult topic you’ll find on your USMLE. In fact, it’s difficult for many of the same reasons as biochemistry. It’s the study of all living organisms that are small enough to require a microscope to see them, and that encompasses thousands upon thousands – even millions – of different organisms. The volume of information that students must retain in order to understand even the simplest concepts in microbiology is staggering. 

Getting a head start on microbiology basics (much like doing the same for biochemistry) can benefit you here, as well. The more of the basic concepts you learn now, the easier it will be for you to learn the more complex ones down the line. 

Pathology

Though it isn’t quite as difficult as microbiology or biochemistry, the topic of pathology presents challenges to most medical students at some point in their education. Pathology is a bridge between science and medicine, and to put it as simply as possible, it’s the study of diseases. There are more than 100,000 identified diseases across the globe, so it’s easy to see why so many students struggle with this particular topic. Fortunately, medical students also tend to find pathology interesting, which can make things a bit simpler. 

One of the best ways to prepare yourself for a difficult pathology course involves reading your course syllabus and obtaining as much of the recommended material as you can early on. The more you can read and understand about pathology before your course even starts, the more the lectures, your textbook,  and other materials will make sense. 

Biochemistry, microbiology, and pathology are the three most difficult topics on the USMLE according to medical students from around the world. In all three cases, the complexity lies almost solely in the volume of information you’ll need to retain and very little on actual comprehension issues. As such, start studying these topics as soon as you can and consider scheduling some extra study time for them as needed, too.

Important Things to Know Before Taking the USMLE Step 1 Examination

USMLE Step 1 Examination

If you are preparing to take the USMLE Step 1 exam, you may be feeling stressed out, apprehensive, or even terrified of failure. One of the best things you can possibly do is educate yourself as thoroughly as possible, and the following bits of information are sure to help you do just that.

Test Format

Familiarizing yourself with the test format can help you feel more at ease when it comes time to test, and fortunately, the first part of the USMLE is pretty cut-and-dry. It consists of seven sections made up of 40 multiple choice questions each, and you’ll have a total of eight hours to finish it. You’ll get a total of 45 minutes during the test session for breaks, but if you finish a section before the allotted hour is up, you can use that time to take a break, too. It’s always a good idea to participate in the optional 15-minute tutorial just before the exam that will help you feel even more at ease.

Application Steps and Cost

To apply for the USMLE Step 1, you will need to apply through the NBME, or National Board of Medical Examiners. If you are from a country outside of the US, you need to register with the ECFMG, or Educational Commission for Foreign Medical Graduates. You will be able to choose a test date from a number of available dates throughout the year, and as of 2018, the cost to take the USMLE Step 1 exam was $605.

The Best Time to Sit for the Exam

If you are curious about the best time to take your exam, it’s important to know that most students opt to sit for it sometime between their first and third years in medical school. You should be able to pass once you’ve passed all your basic medical science courses, and you should always take it before you start your clinical rotation. If you take it at this point, the things you’ve learned are still fresh, but you’ve also had the opportunity to take a couple extra months to study.

Passing Scores and Test Results

In order to pass the USMLE Step 1 examination, you will need to obtain a score of 192. As of 2016, the NBME reported that the average score among passing students was 225 with a standard deviation of about 20. The NBME releases scores to students each Wednesday of the year, and it takes about a month after you’ve taken the exam to get your scores. When they are available, you will receive an email advising you how to check your score online.

The USMLE Step 1 is an important step in obtaining a license to practice as a doctor in the US, and while it can be a stressful event, learning more about it will help you relax and obtain a better score. Remember that you can take this exam as many as six times in your lifetime, too. Study hard and do well in medical school, and you should have no problem obtaining the required score of 192.

How to Overcome a Bad USMLE Step 1 Examination Score

Bad USMLE Step 1 Examination Score

The US Medical Licensing Exam (USMLE) is one of the toughest examinations in existence today. About 4% of students in these programs fail the USMLE Part 1 on their first attempt, and while this can be discouraging, it is certainly not the end of the line. It is possible to retake and pass this examination if you do not allow yourself to be overcome with disappointment, work hard, and try again.

Work with Faculty

If you failed your first attempt at the USMLE Step 1 examination, which is designed to test your knowledge of the material learned in the first two years of medical school, it is vital that you work with faculty and other education specialists to figure out where you need help. Then, once you have this information, you can utilize various study methods to better familiarize yourself with the content. Through diligence and the help of those who want to see you succeed, it is possible to obtain a passing score on your second attempt.

Don’t Fall Victim to the Stigma

Many students who do not pass the exam on the first attempt feel a great deal of shame, particularly when they are the only student among a group of peers to score poorly. However, it is worth noting that students are not ostracized from their study groups or peers in these cases. In fact, your peers who have passed the exam will likely extend their knowledge and tips to help you succeed on your next attempt. Focus on learning what you need to know to provide the best patient outcomes, and never let a perceived social stigma bring you down.

Utilize a Variety of Study Methods

Often, students who do not pass the USMLE Step 1 on the first attempt are those who utilize only one or two different study methods, which can sometimes prove detrimental. Different people learn in different ways, and while some can learn everything they need to know simply by reading the material, others need to repeat it, practice it, and put it to use. Try mock exams, online study tools, flash cards, study groups, and more to give yourself access to the material from every possible angle. Make note of which method seems to provide you with the best comprehension and spend more time with it.

Keep the Facts in Mind

Finally, rather than feeling discouraged, it’s important to remember that you are not the only student who received a bad USMLE Step 1 grade. A study published in Academic Medicine looked at 129,000 students who took the exam for the first time between the years of 1993 and 2000. Though some 6% failed on the first attempt, 90% of those students ultimately graduated medical school and obtained their licensure. This means that only a very, very small percentage of students who do not initially pass the USMLE Part 1 will ultimately fail to graduate medical school.

A bad grade on your first attempt at the USMLE Part 1 can certainly be frustrating, especially if you worked hard and studied. However, there are things you can do to improve your chances of passing on the second attempt – and more than 90% of students in your position do. Utilize these tips, work hard, and focus on the ultimate goal, which is providing the best possible patient care.