As part of the holy UFAPS, UWorld is a must when it comes to USMLE prep. But, as there is with most paid resources, there’s a lot of debate surrounding how best to use it.
So when to start UWorld to really get the most bang for your buck? There are a couple schools of thought…
Many med students agree that starting UWorld straight away (and doing several passes) is best. Others argue for working on your conceptual foundations first (and understanding the material) before starting. Each options has its pros and cons.
We’ll dive into those in this article. We’ll also cover:
- Why you don’t want to miss out on starting UWorld
- What med students on Reddit say about being the best time to start it
- Other useful beginner tips for getting the most out of UWorld
As a med student who knows how stressful it can be preparing for the USMLE, I understand how useful it can be to try and answer questions relating to it. Often just seeing other people’s opinions on it (and the “best practices” they recommend involving key study resources) can make you feel a bit better.
Ready to find out more? Let’s get into it.
Why start UWorld?
Question banks like UWorld are super important to helping med students score well in their USMLE board exams. According to their homepage, 90% of U.S.-based med students use it.
With quizzing a key part of evidence based study strategies (including active recall), the practice comes close to mirroring the actual exam itself.
Practicing with UWorld, a question bank (“qbank”) held up as one of the “gold standard” resources for USMLE prep, med students can reinforce and apply the knowledge they’ve built up over years of preclinical classes.
Wondering when’s best to start it is important for two main reasons:
- UWorld is huge (3400+ USMLE Step 1 questions and growing)
- It costs money ($369 for 90-day access)
So it’s not like med students have all the time in the world to think about completing it…
Not if they don’t want to waste their valuable time and money!
When’s best to start UWorld: examining the strategies
Let’s revisit both lines of advice from the intro.
Strategy #1: start UWorld straight away
The argument for chipping away at the questions on UWorld as soon as you start med school is very convincing. Some students argue you can learn directly from seeing and attempting lots of questions, despite fully understanding the context.
But let’s take a deeper look at the pros and cons.
- Ensures you finish the entire question bank
- Allows time for multiple passes (further practice)
- Eases you into MCQ-style questions from day one (allowing you develop your technique)
- Helps with reinforcement of the concepts you study from other resources (classes, books etc)
- You’ll have more time to “learn” about each concept
- Involves a time commitment (at the sacrifice of internal exams/mid-terms)
- Plenty of evidence of students completing UWorld during dedicated (and scoring well)
- Seeing questions you have no idea about (unless you additional time understanding them) can prove a time waste
Personally, I feel this is still probably the best strategy. Especially if you focus on UWorld questions that are specific to your blocks (i.e. completing all biochemistry relevant questions as you finish up your biochemistry classes).
Strategy #2: start UWorld during dedicated
The argument of leaving UWorld until you begin your dedicated study period for USMLE Step 1 is equally convincing.
Here are the pros and cons of this strategy…
- You’ll have a solid foundation (or at least exposure) to most of the tested concepts (helps with motivation)
- You can use the time you save to get more question bank exposure (with other platforms like Kaplan, rx etc.)
- Timing-wise it’ll be closer to your final exam (refreshing the concepts)
- Tight time constraint (you’ll be under pressure to complete it or have multiple passes)
- Could feel rushed covering all the concepts and ensuring you understand them deeply enough
- Depends how long your dedicated period is (I’d estimate you’d need at least six weeks to get through all of UWorld)
As a student you’ll need to weigh up the pros and cons of both these solutions carefully.
You’ll want to absolutely aim for at least one full pass however!
When to start UWorld: Reddit’s recommendations
The consensus is a bit mixed over on Reddit among med students and the subject of when’s best to start UWorld.
Some of the more useful comments include:
Start immediately. The biggest omission in the process of preparing for step one is beginning questions late. Start the questions as soon as possible.u/juststepone
With the argument being you’re better off entering dedicated with 2K+ questions under your belt first.
But then others feel the opposite is true…
Uworld doesn’t make any sense at all until you’ve synthesized and essentially learned all the info. Wait until you’re 1 month out from dedicated and then start with 60-80 Q’s a day. You’ll finish it twice easy.u/STEMI_stan
With the obvious cons here being the size of UWorld; where 80 questions can take anything up to 2 hours (even more for review and a second pass etc).
So, a middle ground could be the best option. As suggested by this user…
I personally think you can start maybe 1 or 2 months before dedicated. It was overwhelming to do a bunch of questions on top of first aid and sketchy. I’ll say do 20q a day before dedicated then 40 a day as you enter dedicated.u/jbub8314
Of course everyone has their own opinions. Some even suggest using other question banks first (alongside your classes) and then working toward UWorld later…
I’d say use Kaplan or rx until like 12-14 weeks out from your exam and then go hard with UWorld doing 40 questions in random, timed blocks while carefully reviewing the answer explanation and the related pathophysiology.u/dontbeaFOOSH
But something that is essentially agreed upon (among all students) is to at least use and complete UWorld!
UWorld Beginner Tips
Here are some extra tips that can help you plan around your starting point with the resource.
Should I do UWorld twice?
Most med students believe that two passes of UWorld is best in terms of prep.
The first pass will help you understand what’s tested, where your strengths and weaknesses lay after attempting questions and will give you time enough to go away and fill those knowledge gaps.
The second pass will help you master the platform. You’ll recall and apply your knowledge, understand where and how to apply question answering technique and also grow in confidence as you see your number of correct answers go up.
What is the best way to use UWorld?
The best way to use UWorld is to factor in how much time you’ll have to complete it.
Here’s how to do that:
- Figure out how many questions you plan to answer (at the time of writing there’s 3500+ in UWorld’s Step 1 block)
- Measure how many days you have up until you want to complete your first pass
- Calculate how many questions per day you’ll have to do to reach that milestone
Of course it’ll be hard to estimate how long it will take you to answer questions the first time out. They differ in length and some you’ll be able to complete faster than others. That’s why the above should be a rough guide only.
You’ll want a good workflow too. For most students that means working through UWorld with a good reference book (First Aid for USMLE is the most recommended) to annotate as you go.
Make sure you track all your incorrect answers, drill the concepts and even make flashcards from them. Then periodically test (spaced repetition) these missed questions over time.
How many UWorld Questions should I do per day?
The answer to this depends on what’s discussed above. It will differ for you depending on your goals.
As a good measuring post, consider a student who has a 6 week dedicated period to work through UWorld and only complete a single pass.
In this case they’ll need to get through 1 or 2 blocks of 45-50 questions per day.
That’s where those times factor in. Consider doing a 40 question run through and work out your average time spent per question. That could help you plan more accurately.
How do I make UWorld faster?
Every student will run through it at their own pace. For some that could be deadly slow. For others lightning fast. Don’t compare yourself to others.
Some ways to speed up your run through include:
- Skip book annotations and pull cards testing missed/unclear concepts directly from pre-made flashcard decks (Zanki/Anking being my favorite)
- If you start straight out, only practice questions relevant to your blocks/school classes (this will ensure you don’t waste time skipping around concepts)
- Look for key words/concepts. Examine short-cuts in questions that can save you the extra time of reading the whole scenario/case.
- Keep practicing. The more you do, the more you’ll drive down your average time spent per question.
What is a good first pass UWorld score?
I don’t think it pays too much to worry about your score during your first pass. Focusing too much on it is no real benchmark for how you’ll score during the real test.
Most students tend to agree that anything around 50% or over is pretty good however.
As long as you aim to improve on whatever score you get during your second pass (and achieve it), you know you’ll be making progress!
Starting UWorld right away or closer to dedicated is a personal decision.
If you know you won’t have a very long dedicated period for prep (or think you’ll be feeling very stressed or pressured), it could be best to start right away. Otherwise, especially if you’re confident you’ll have covered all the material, it might be better to save it.
Hopefully this guide has helped give you a better idea of the questions to ask yourself to come up with the ultimate strategy.
Born and raised in the UK, Will went into medicine late (31) after a career in journalism. He’s into football (soccer), learned Spanish after 5 years in Spain, and has had his work published all over the web. Read more.