May 30, 2008

Question Banks

The most important prep tool to help you with your studying for Step 1 is a good question bank. Initially, it's hard to tell what makes one question bank difficult and obscure and another, representative to the real USMLE yet challenging (read: high yield enough that you will get those 10% off-the-wall questions correct.) That's why you need to do multiple question banks! They used to come in book forms... I acquired a set of these question books from an upperclassman and then I promptly ditched them. The USMLE question and answer format has evolved over the years and your question bank should follow suit.

Here's my breakdown of the different Qbanks.


By far, my favorite qbank. I call it Qworld.

  • It has "world-class" explanations in their tutorial answer choices, making it an extremely good study source.
    To be honest, when I started studying for a new subject, I'd read for half a day and then just sit down and do Qworld in the tutor style. That was all the studying I needed for some subjects! No need to go back to the same old review books and fall asleep reading them if you know enough of it already. It's much better to engage yourself with active learning.
    Just take the time to read all of the answers and take notes directly in First Aid of the material you don't know. I used a fine-point sharpie so these points jump out more.
  • The FRED software format seen on the real NBME is very similar to the Qworld's.
  • The highlighting/greying out function is excellent! Get in the habit of using it as you read through the question. I noticed that when I faded out in blocks 5 and 6, I could still answer the questions because I reflexively highlighted the important facts.
  • You can "mark" questions along the way and test yourself on this material.
  • The Review tab shows your previous tests by Subject matter and Subtopic and Specific topic!
    i.e. Embryology: Cardiology: Tetralogy of Fallot
  • You can also opt to review just the questions you marked, the ones you omitted, the ones you got incorrect or the ones you got correct.
    This makes it very helpful for mentally reciting the correct answers in your head during your second and third review-recall sessions.
  • The only down-side (if it could really be called that) is that there is no way to electronically copy the material. You can't hit "print-screen" or "copy/paste" the text into a picture or document format, for copyright protection purposes.
    If USMLE World provided its tutorial explanations and pictures in a book format, it would surpass Kaplan by far!

By the makers of First Aid!

  • Unfortunately, I don't know much about their question bank.
  • It's the cheapest of all the pay-per-month Qbanks! I was surprised to learn that. I thought Qworld was the cheapest.
  • I was advised to buy Kaplan and USMLE World since I had the softcover book version of First Aid Q&A. I did a few sections of the book and it was decent.
  • Q&A is broken down into subsections (identical to the Subjects in First Aid) with about 25-50 questions per section. Then there are a series of random 50-block questions, for a total of 4 or 5 test blocks.
  • My only regret in taking the exam earlier than my classmates was that I didn't have the time to devote to this test booklet or try out USMLE Rx.
  • If you've used it, let me know in the comment section what you thought about it. :)

Kaplan QBank
This one is interesting. A representative flew in from the mainland to tell us all about the USMLE. I went for the pizza and soda. There's several programs you can sign up for with incremental costs: Qbank, IV QBank, books, lectures, whatever.

  • The books are worthwhile if you don't have any other study material for the subject. I started off using them and soon drifted away as I had a whole set of High-Yields/BRS books to read alongside lecture notes, which sufficed.
  • The lecture series are good if you do them EARLY. Do not wait until your final few weeks to listen to them! I highly recommend the Behavioral Science lectures (the guy is entertaining and memorable) and the Pharmacology lectures.
  • The IV stuff is a waste of time, according to my friends.
  • The only thing you really, absolutely need is QBank. And even there, you run into a few snags.
    Kaplan's Qbank is esoteric at times. It doesn't give you the full stem so you have to rely on the one-fact, one-answer style of recall (IMHO, this is a waste of time!)
    The software is horrible. There is a lot of lag shifting between questions. Sometimes the graphics don't load. The highlighting rarely works, I have to double click or highlight backwards half the time. And then it gets erased or random portions of the answers are highlighted. Oh and most importantly -- you cannot highlight the answers! How are you supposed to review like that?
  • That said, Qbank isn't bad. However, it's not the best. I preferred Qworld because I could see the specific topic of the questions I got wrong when I reviewed (Kaplan just shows the topic header) and it's faster and more reliable.

Wiki Test Prep
The up and coming contender in the question bank world. There are a few gems here -- namely, it's free and you can find out what your score is after each test you take.

  • Since it's a wiki, you have to be somewhat cautious and you shouldn't take the answers (sometimes, even the question) at face value.
  • I'd say the best exercise comes from reading "Tips on Question Writing" and "See Question Template" (under the Question Body subheading.)
    Learn how question stems branch off of basic scenarios into variant physical exam and lab findings.
    Be capable of predicting at least one prompt question in each subject.
    Predict what answers will be provided alongside the real answer: similar names to confuse you? similar etiology? perhaps its the right answer except for that one (or two, or three) lab findings that don't seem to fit?
  • Submit questions! I'm planning on doing that next week as I fire up SuperMemo for my computer and flip through First Aid to recall the questions (and style, mostly) I had on the USMLE Step 1.

Well, hopefully that helps. :)

I'll talk more about mental question formation, subject review and methods for recall in upcoming posts. Stay tuned!


  1. the content of the real thing is very similar to USMLE world, but I am certain I went over at least 6-7 questions that were almost exactly as ones I had on USMLE world, save for simple differences in the wording and options.

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