The Study Tools Students Should Actually Be Using

Kolin M. Meehan

Disclosures

February 01, 2018

Every medical student feels the pressure to perform, despite the paradigm shift to pass/fail systems. Medical schools inevitably rank students, if not by hard metrics like test scores then by soft skills that fall under the professionalism umbrella. Residency programs, in turn, pack these metrics into their decision to rank applicants as prospective trainees.

The primary hurdle for students begins at step 1; that is to say, it begins with the US Medical Licensing Exam (USMLE) Step 1. No amount of preparation ever seems to be enough for the single most important test a budding doctor will take. Yet surviving Step1 merely initiates a series of exams that stand between you and your medical degree. Furthermore, transitioning to the clerkship years challenges students to test their bank of knowledge in real time. Responsibilities now include rounding with the care team, researching histories, and developing care plans for patients. All the while, students must prepare for shelf exams with the intent to sit for Step 2 at the end of the third year.

Medical students have an appetite for success and require reliable, effective materials to study. As such, test prep companies have responded to this demand by flooding the market with dozens of books, review courses, flash card sets, and question banks. The number of options quickly mushrooms to the point of paralysis.[1] Sadly, a paucity of independent analysis is available for the vast amount of resources. From the few studies available, an interesting trend appears to shed light on the best approach to succeed on standardized medical exams.

Red Book, Blue Book, Old Book, New Book

The harsh reality is that medical students face an overwhelming flood of information in 4 years of school. Having a comprehensive guidebook with which to synthesize the clutter of facts into a coherent message remains paramount. In fact, virtually everyone pursuing an MD must first master the FA (First Aid). This bible becomes every medical trainee's go-to source for a thorough overview of the lessons found in the classroom, the lab, and the hospital.

In fact, a wise upperclassman once claimed that memorization of First Aid was practically required to excel on USMLE tests. One caveat: This student earned one of the highest Step 1 scores ever at his home institution. But as I'll detail later, other factors may have contributed to his success.

Diving deeper into a particular subject for shelf exams requires a more specialized book series. Publishers—including the Board Review Series, Case Files, Kaplan, Deja Review, and countless others—offer in-depth compositions on family medicine to surgery and everything in between. Yet anxiety inevitably sets in when students mull over picking the "best" from the rest: Informal student polls and blogs fail to identify the superior resource for each subject, let alone the dominant series for all core rotations.[2,3,4]

Fortunately, a forest can be seen through the trees: All reports suggest choosing one or two books on each subject (even combining those from different publishers) and sticking with them during each rotation. This way, students gain a sense of consistency that will increase the odds of retaining information for the tests. However, reading is only half the battle.

How do you know everything stuck?

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