How to Not Freak Out While Prepping for Step 1

By Luke Murray

So, you’re sitting down to start studying for Step 1 and you’re freaking out. That’s understandable. I sure as heck did. It’s the most important test that you’ll take on your journey to becoming a physician.

The problem with worrying was that it hurt my chances of not just success on the test, but on my quality of life and attitude surrounding all things Step 1. I remember getting overwhelmed with information and so concerned that I hadn’t read enough that I would just bang through material without understanding anything. I also remember being a nervous wreck whenever I wasn’t studying, making me a burden to be around. I even pouted about not doing as well as I’d liked despite all the worrying I’d done, while others did better and seemed to stress less. It was as if putting myself through all that (unnecessary) mental anguish made me feel like I deserved to do better.

The fact is, quality and volume of preparation are the ONLY things correlated with good performance. ‘Caring’ or ‘Worrying’ or ’Thinking about it’ is at least as mentally taxing as actually studying, but these things make you do worse instead of better.

Still, I think if someone told me these things back when I was studying, it wouldn’t have helped me. I would have said, “Yeah, but do you REALLY realize how important this test is and how screwed I am if I don’t do well on it?” I would have echoed the sentiment of that first paragraph ad nauseum. I was even blind to how much I was worrying, let alone its consequences. But now, with the benefit of time and distance, I can say I wish that I’d done these two things differently:

1. Recognize worry when it happens, and then ask some smart questions.

Why am I anxious now? (eg. I’m getting behind schedule, this section is hard)

What can I do to fix it? (i.e. remake a schedule that’s more reasonable, slow down and understand this content)

2. Dig to the root of it all. Why am I anxious at all about this test? You’re obviously worried, but worried about what scenario, specifically? Realize that the overall concern – not getting to do what you want to do when you grow up – is statistically very unlikely (90% of people match into the specialty they want). And even in the worst case scenario, your life can work out just fine.

The ironic thing is, the biggest contributor to my poor performance was the anxiety created by the possibility of poor performance. So, recognize when you’re worrying, dig to the root of it all…and above all else, keep calm and study First Aid.