How to Become a Better Test-Taker for the USMLE

By Alyssa Missant, MD

It’s one of the most common pain points we hear from students: “I study hard and know the content, but I just don’t perform well on test day.”

If this sounds like you, you’re not alone—and you’re not doomed. Becoming a better test-taker is a skill that can be learned and improved with the right mindset and strategies.

Here are some practical, high-yield strategies we teach our students at USMLE Pro to help them become stronger test-takers for Step 1, Step 2 CK, shelf exams, and beyond.

1. Use Process of Elimination as Your Default Strategy

If you take only one thing from this post, let it be this: start every question by eliminating the wrong answers.

Many students read a question and immediately try to jump to the right answer. But that approach can backfire, especially when you’re unsure. By systematically ruling out options that are clearly incorrect, you narrow the field and increase your odds—while also reinforcing critical reasoning skills.

Pro tip: Even when you think you know the answer, do a quick sweep of the other options. Sometimes you’ll catch a better choice or realize your initial pick doesn’t fully match the stem.

2. Ask: “What Concept Is This Testing?”

Here’s something that students often forget: USMLE questions are not real clinical scenarios—they’re carefully written to test a concept.

Always ask yourself: What learning point are they trying to test here? This reframes the question from a narrative into a targeted assessment.

Let’s say you’re reading a Step 2 CK question about a 72-year-old man with a hip fracture. That’s the clinical setting—but what’s the teaching point? Is it delirium prevention? Pain management? Anticoagulation risk? When you identify the likely target concept, everything else falls into place.

3. Interrogate the Details: “Why Include This?”

Every detail in the stem was written with intention. So if a piece of information seems random or out of place, it probably isn't.

Try this mindset shift: If X were the correct answer, why would they include Y? This reverse reasoning helps you spot inconsistencies between the answer choices and the question stem.

If a patient with chest pain has normal EKG findings but the question still includes mention of pleuritic pain and recent travel, those clues probably matter more than the normal EKG.

Don’t gloss over odd or specific details—they’re often the key to solving the question.

4. Stop Believing the Exam Is Trying to Trick You

Many students fall into the trap of overthinking because they assume the exam is trying to mislead them. Let’s be clear:

The USMLE is not trying to trick you.

Exam writers are not trying to stump you—they’re trying to test whether you understand the underlying concept. That means:

• The simplest answer is often correct.

• There is usually one best answer, not multiple “close” ones.

• If you find yourself overanalyzing, zoom out and simplify.

By shifting your mindset away from defensiveness and toward clarity, you’ll reduce test-day anxiety and improve accuracy.

5. Don’t Change Your Answer Without a Really Good Reason

We’ve all been there: lingering on a question, doubting your instincts, and second-guessing your original choice. But here's a golden rule:

Only change an answer if you remembered a critical fact or noticed a new, relevant detail in the question stem.

Changing an answer just because of a “feeling” is almost always a mistake. Your first instinct is usually right—unless you have new, solid information to guide a change.

At USMLE Pro, we teach students to trust their process. When you have a system and stick to it, you make fewer impulsive decisions under stress.

6. Always Do Two Passes

Time management is one of the most overlooked test-taking skills. If you don’t know the answer within a minute, don’t waste valuable time.

Instead:

• Mark the question.

• Make your best guess.

• Move on.

Then, come back on a second pass. You may find that another question on the exam jogs your memory or clarifies a concept. Or, after a mental reset, the answer will be more obvious the second time around.

This approach also prevents panic—you know you’ll have another chance to review tricky items, so you don’t spiral if one question stumps you.

7. Don’t Be Afraid to Get Help

There’s a quiet myth in med school culture that you’re supposed to succeed on your own. In reality, many students—especially those scoring highest—get help.

Whether it’s working with a tutor or studying with a strong test-taking peer, external feedback is one of the fastest ways to improve.

Trying to fix your own test-taking issues is like trying to give yourself therapy. You’re using the same thought patterns that led to the problem in the first place. Having someone else observe your process, catch your blind spots, and coach you through new approaches can make a massive difference.

Final Thoughts: Test-Taking Is a Skill, Not a Personality Trait

If you’ve ever said, “I’m just not a good test-taker,” it’s time to reframe that belief.

Test-taking is not a purely innate talent—it’s a learnable skill. And like any skill, it gets better with practice, feedback, and strategy.

At USMLE Pro, we specialize in helping students not only master the material—but also build the skills to confidently approach any question, under any condition. If you're doing the work but still not seeing the scores you want, the issue might not be what you know—but how you're showing it on test day.

Alyssa Missant, MD is a board-certified psychiatrist and the founder of USMLE Pro. She is passionate about teaching, coaching, and mentorship, with a special focus on supporting students facing anxiety, burnout, ADHD, and other mental health challenges as they navigate medical school and residency.

Want to become a better test-taker?

Schedule a free call with Dr. Missant to get a personalized assessment of how you can become a better test-taker, or sign up online to get matched with an expert tutor who understands both the content and the psychology of high-stakes exams. We’re here to help you study smarter—and score higher.