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How to Approach the USMLE Questions: Test-Taking Strategies for the USMLE Exams

  /  Blog   /  How to Approach the USMLE Questions: Test-Taking Strategies for the USMLE Exams
how to approach USMLE questions

Answering USMLE questions requires both knowledge and test-taking skills. Most students are familiar with the content and have adequate knowledge, but they perform poorly in USMLE exams because they lack the test-taking skills.

To do well in challenging examinations like USMLE, you need to study hard, be dedicated, use valuable resources, and get guidance from USMLE tutors, who have experience with these types of exams and who’ll help you with resources and test-taking strategies.

A profound amount of knowledge doesn’t guarantee a good score if you don’t have the correct USMLE question approach. That’s why developing your test-taking skills is crucial for USMLE success.

This article gives you insights into the anatomy of USMLE questions and the test-taking skills you need to hone to ace your USMLE.  


Test-wiseness, first conceptualized by Thorndike in 1951 is the capacity of the examinee to utilize the format and characteristics of the questions in the test to achieve a high score.

If you are test-wise, you can perform well in almost any test situation. Being a wise test-taker, you have a better attitude towards the tests, less test anxiety and ability to achieve better scores.


The USMLE exams consist of multiple-choice questions. Each question has 4 or more choices. The answer is the one that is the best of all the answer options available.

A USMLE question is made up of these 3 parts:

  1. Stem (or clinical vignette): It contains the information of the patient or question from where you need the data required to answer the question.
  2. Question: The question follows the stem. You’ll have read this part of the question carefully to understand what is being asked.
  3. Answer options: These are the choices given to answer the question. One of them is the answer; the rest are distractions. To choose the correct one from the available options takes practice and USMLE preparation.


  • Wrong attitude toward the exam. A positive outlook improves your exam day performance.
  • Failure to manage time.
  • Failure to read carefully the question and stem.
  • Failure to understand what is being asked for in the question.
  • Changing a well-thought answer when in doubt.


  1. Read the question first: Before reading the stem, focus on what is being asked.
  2. Read the stem: After understanding clearly what is being asked in the question, you read the stem to look for information to answer the question.
  3. Choose the answer: Choose the option that best answers the question.

There are also other ways to approach a question. Some people read the question first. Then check the available answer choices, and later read the question stem. This approach works for some people and is valid too. However, it adds an extra step to the process, which can be limiting factor, especially when you have a time constraint.

Whatever USMLE question approach you take, make sure that you practice and become familiar with it to master it.


  1. Do not panic when you see long question stems. This may happen, especially during your USMLE Step 2 CK and Step 3 exams. Most of the times, long questions are easier to answer.
  2. Spend some time in reading and analyzing the USMLE questions, especially the stem. Do not rush to choose an answer.

If you are stuck with a question and it’s taking more time than required, your best bet would be making an educated guess and moving on to the next question. Chances are that you may get the answer wrong, but you’ll have the time to answer other questions correctly.

  1. There is no penalty in doing guesswork. The best way to increase the probability of getting an answer right is by using the process of elimination. Eliminate the options that are definitely not the answers, and then with whatever options left, make an educated guess.
  2. Always attempt USMLE questions sequentially. If you don’t know the answer to one of the questions, don’t skip the question; make an educated guess and flag it. After completing your test, you can come back to the flagged questions if time permits.
  3. If the question has a picture given, don’t panic. Just read the question. You may not even need to look at the picture.  Sometimes, the picture is just there to distract you.

The test-taking strategies for the USMLE exams mentioned above will help you to approach a question in a more appropriate and effective way. Test-taking skills don’t come easily; it requires practice on a daily basis.

NYCSPREP has experienced USMLE tutors who can help you to master the art of answering questions correctly. Contact us today!

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