Timing IS Everything…


“If only I had more time,” is a common lament of students as they walk out of the USMLE. The simple fact is the USMLE is a timed test. And time matters. No, time by itself does not determine your score. But the time limits that govern each exam provides a constraint that restricts your potential and lowers your score. Having the knowledge is not enough. You have to able to show what you know. And you can only show that which time allows.

Time provides a palpable physical constraint. You have only one hour for each block of questions. When time runs out, the question block is over and you are not allowed to finish it. If you do not get to a question, you will not gain the potential point that question would provide. A question that you never get to is one you will never get right. With more time to think, with more time to reflect, with more time to be sure you get to each and every question, your total score would certainly improve. But you do not have more time. Therefore, it is imperative that you learn to make efficient use of the time that you do have.

Making the most of every minute requires efficiency. Here are three tips to help you get the most out of your limited time:

  • Practice a question routine. Learn and practice a question answering routine before you take your exam. Develop a set behavioral routine in which you do the same steps with each and every question you encounter to reduce wasted effort. A practiced habit for answering questions will free you from focusing process and allow you more time to mentally absorb the question and think though the content issues you encounter. A practiced question routine means more questions covered in less time.
  • Spend the bulk of your time on the question stem. As you consider each question, spend the most time on the question stem where it will do you the most good. Each question can be seen as having two parts. The question stem, which presents material in a clinical case format, and the options, which list the available answer choices along with a corresponding letter. A good rule of thumb is that 75% of your time on any question should be spent reading and thinking about the question stem, and only 25% should be spent on the options. The key to each question in the question stem. Read it carefully, but only read it once. You do not have time to read the long question stems on the USMLE twice. Then, when you turn to the options, be decisive and make your choice.
  • Make yourself choose faster. If you find yourself chronically short of time, the best solution is to train yourself to choose faster. Do not short change your time reading the question stem. You need time to take in the information provided and to gather the clues provided. The way to gain more time for yourself is to make yourself pull the trigger, force yourself to make a choice as soon as you can. Research suggests that the time we spend on the question options can be divided into two parts. The first part we spend considering our choices and actually making our decision. The second part of the time we spend reconsidering, double checking, and doing other things to try to make ourselves more comfortable with the choice that we have really already made. This search for comfort does not improve answer, but simply wastes time. At this stage we are not seeking a better decision, rather we are feverishly trying to feel good about the decision we have already made. Train yourself to give up this search for comfort. Make your decision, live with it and move on!

Along with these physical constraints, time also provides a psychological distraction.  Just knowing that time is limited increases your anxiety and causes you to lose focus on the task at hand.  Every moment you spend thinking about the clock is a moment where you are not considering the questions before you on your exam. As the end of the block nears and the time grows ever shorter, actual panic can erupt.

How do you learn to deal with the distraction that time limits induce? The most basic solution is to make sure you do all of your practice questions under time constrains so you can become accustomed to the feeling of the seconds slipping away. The clock is always running. You can’t stop it. But you can get used to the feel of the time limits and learn to pace yourself accordingly. Time limits are most distracting when you as not used to them. Use your practice experiences to train yourself to see time limits not as an additional thing to worry about, but as a basic fact of life.

Time limits can not be discarded on the USMLE. They are real, and they matter. But, adequate preparation and practice can convert the terror of time into a simply part of your question answering routine. You can not slay the beast of time, but you can tame it. The question is simply, who will be the master? Will you learn to control your time, or will time control you? The right choice to this question is clear. By learning to control your time on your exam, you are learning to control your own destiny. And if you do that, then nothing, not even the pressure of time will keep you for achieving the success that you deserve.