How to Solve UWorld the Right Way (The Complete Method)

UWorld is the gold standard.

Everyone knows this. Everyone buys it. Almost everyone uses it wrong.

I watch students treat UWorld like an assessment tool during their base building. They do 40 questions, score 45%, panic, and think they're failing. They spend 3 hours analyzing a single question. They write paragraphs of notes that they'll never read again.

Or worse — they save UWorld for the end. They think they need to "learn everything first" before "testing themselves." So they watch videos for months, then finally start UWorld with 4 weeks left, realize they don't know anything, and panic.

Both approaches are wrong.

UWorld is not primarily an assessment tool. UWorld is a learning tool. The most powerful learning tool you have.

I scored 45% on my first Renal blocks. 35-38% on my first CNS blocks. And I passed all three Steps in under 11 months with strong scores.

Here's exactly how to use UWorld.

The Mindset Shift: Learning, Not Testing

Before we get into the method, you need to understand this:

Your UWorld percentage during base building does not matter.

Read that again.

You are not supposed to score 80% on your first blocks of a system. You haven't learned the material yet. UWorld is teaching you the material.

The purpose of your initial UWorld blocks is to understand HOW they test First Aid content. 70% of UWorld questions are testing concepts directly from First Aid. The same topics keep appearing in subsequent blocks.

Your initial blocks are for learning patterns. Your later blocks are for raising your percentage.

If you let low scores demoralize you during your first blocks of a system, you've already lost the mental game.

You are not God. You are not a genius. Nobody is a genius. You will get questions wrong. That's the point. That's how you learn.

The Setup: Tutor Mode, System-Wise

Here's exactly how to set up your UWorld blocks during base building:

Mode: Tutor (always)

Questions: Unused (or All if you've reset)

Subjects: Select All

Systems: Select the ONE system you're currently studying

That's it. You're doing system-wise UWorld in tutor mode.

Why tutor mode? Because you need to see explanations immediately. You need to learn from each question before moving to the next. Timed mode is for later, during your NBME phase.

Why system-wise? Because you just finished reading First Aid for that system. The questions will reinforce what you just learned. You'll see how concepts get tested. You'll start recognizing patterns.

Why one system at a time? Because you cannot say you've completed a system until you've done 100% of UWorld questions for that system. Don't leave questions for later. Complete each system fully before moving on.

The Solving Method: Question by Question

Here's exactly what happens when you're solving UWorld questions:

When You Get a Question WRONG:

Step 1: Mark/flag it immediately

Don't skip this. Every wrong question gets flagged.

Step 2: Read why YOUR answer was wrong

Don't just read the correct answer. Understand why you chose what you chose and why it was incorrect.

Step 3: Read why the CORRECT answer is correct

Understand the logic. Understand the reasoning.

Step 4: Read the educational objective

This is gold. The educational objective tells you exactly what concept this question was testing.

Step 5: Highlight key lines in the explanation

Don't highlight everything. Highlight the 1-2 lines that explain the core concept.

Step 6: Move on

Do not spend 30 minutes on one question. Do not write paragraphs of notes. Read, understand, highlight, move on.

The entire process for a wrong question should take 3-5 minutes maximum.

When You Get a Question RIGHT But Your Logic Was Wrong:

Same process as a wrong question.

You got lucky. You guessed. Your reasoning was flawed but you happened to pick the right answer. This is dangerous — you think you know something you don't.

Step 1: Mark/flag it

Step 2: Read the full explanation

Step 3: Understand the CORRECT logic

Step 4: Highlight key points

Step 5: Move on

Treat these questions as if you got them wrong. Because conceptually, you did.

When You Get a Question RIGHT With Correct Logic:

Step 1: Quick read of the explanation

Just confirm your reasoning was correct.

Step 2: Don't mark it

Step 3: Don't spend extra time

Step 4: Move on

You knew it. Great. Don't waste time on what you already know. Focus your energy on what you don't know.

The Review Process: Connecting to First Aid

After completing a block (or every 10 questions if you prefer), you connect everything back to First Aid.

Step 1: Go through your flagged questions

Step 2: For each flagged question, find the concept in First Aid

The educational objective tells you exactly what to look for.

Step 3: Highlight that section in First Aid

One line. One concept. Highlight it.

Step 4: Move to the next flagged question

That's it. You're not writing notes. You're not creating flashcards. You're finding the tested concept in First Aid and highlighting it.

Why this works:

You're building a map of tested content. Every highlight represents a concept that UWorld tested. By the time you finish all systems, your First Aid is covered in highlights showing you exactly what's high-yield.

Time investment:

• Solving 40 questions: ~60-90 minutes (in tutor mode)

• Reviewing flagged questions and highlighting First Aid: ~30-45 minutes

• Total per block: ~2 hours

Daily target: 40-50 questions + review

The Block Progression Within Each System

Here's how your UWorld performance should progress within a single system:

First 1-2 blocks: Expect 40-55%

You're learning. You're seeing patterns for the first time. Low scores are normal and expected.

Don't panic. Don't get demoralized. This is part of the process.

Middle blocks: Expect 55-65%

Patterns are becoming familiar. You're recognizing question stems. You're connecting concepts.

Still learning, but now with momentum.

Final 2 blocks: Expect 60%+ (ideally 65%+)

This is your benchmark. If your last 2 blocks of a system are above 60%, you understand the system well enough to move on.

If your last 2 blocks are below 60%, you need more reinforcement before moving on. This is when you watch Mehlman Medical for that system.

The principle:

Initial blocks = learn how they test First Aid Later blocks = raise your percentage to prove understanding

Don't move on until your last 2 blocks are above 60%.

What NOT to Do With UWorld

Mistake 1: Saving UWorld for the end

I see students do this constantly. They watch videos for 3 months, "preparing" for UWorld, then finally start with 4 weeks left.

This is catastrophically wrong.

UWorld is how you learn. Watching videos without doing questions means you're not actually learning — you're just consuming content.

Start UWorld immediately after reading First Aid for a system. Not after finishing all videos. Not after "memorizing" everything. Immediately.

Mistake 2: Doing random mixed blocks during base building

Don't do random 40-question blocks mixing all systems. That's for later.

During base building, you do system-wise UWorld. You just learned Renal? Do Renal UWorld. You just learned Cardio? Do Cardio UWorld.

Mixed blocks come during your NBME phase when you're simulating exam conditions.

Mistake 3: Doing timed mode during base building

Tutor mode during base building. Always.

You need to see explanations immediately. You need to learn from each question before moving on.

Timed mode is for NBME prep when you're practicing pacing and stamina. Not for learning.

Mistake 4: Spending 30+ minutes on one question

I see students analyze a single question for an hour. Reading every explanation. Researching on Google. Writing extensive notes.

This is wasted time.

3-5 minutes per wrong question. Read the explanation, understand the concept, highlight in First Aid, move on. You'll see similar concepts again. Repetition through more questions is more effective than deep-diving on one question.

Mistake 5: Writing extensive notes

Your notes are your highlighted First Aid. That's it.

Don't create a separate UWorld notebook. Don't type up explanations. Don't make flashcards from every question.

The highlight in First Aid IS your note. It tells you: this concept was tested.

Mistake 6: Resetting UWorld too early

Don't reset UWorld until you've completed 100% of all questions at least once.

Some students reset after doing 50% because they want "fresh questions." Now they have no way to track which systems are complete.

First pass = 100% completion of all questions, system by system.

If you need more practice after that, then consider a reset. But only after first pass completion.

Mistake 7: Leaving questions for later

"I'll finish the last 200 Renal questions later."

No. Complete 100% of a system's questions before moving on. You cannot say you've completed a system until every single UWorld question for that system is done.

Leaving questions for later means you never do them, or you do them out of context when you've forgotten the system.

Special Situations

What if RX isn't working?

In my system, you do RX subtopic-by-subtopic while reading First Aid, before starting UWorld.

But sometimes RX doesn't give free trials. Sometimes it's glitchy.

If RX isn't available, use UWorld subtopic-wise instead:

1. Go to UWorld

2. Select the system

3. In the subtopic dropdown, select specific subtopics (anatomy, physiology, etc.)

4. Do 5-10 questions per subtopic as you read First Aid

Same concept as RX — understanding how they test what you're reading — just using UWorld instead.

RX is easier (questions are simpler, eases you into the style). UWorld is harder but still works.

What about questions on topics you haven't studied yet?

In system-wise UWorld, you'll occasionally get questions mixing in other systems (Cardio question in your Renal block, for example).

This happens because the real exam mixes everything.

If you encounter a question from a system you haven't studied:

1. Do your best to answer

2. Read the explanation

3. Don't highlight in First Aid yet (you'll cover this when you study that system)

4. Move on

Don't stress about cross-system questions. You'll cover those systems eventually.

What if you're scoring below 40% consistently?

If you've done 3+ blocks of a system and you're still below 40%, something is wrong with your First Aid reading.

Go back. Watch Mehlman Medical for that system. Re-read First Aid with better understanding. Then continue UWorld.

Don't just keep grinding blocks hoping the score improves. Diagnose the problem and fix it.

The UWorld Completion Checklist

For each system, before you move on, confirm:

☐ I have read First Aid for this system with PDF guidance ☐ I have done RX (or UWorld subtopics) while reading ☐ I have completed 100% of UWorld questions for this system ☐ My last 2 blocks are above 60% ☐ I have highlighted tested concepts in First Aid

If any of these are incomplete, you're not ready to move on.

How UWorld Connects to NBMEs

Once you've completed all systems with UWorld, you'll start taking NBMEs.

Here's the connection:

• UWorld taught you HOW concepts get tested

• NBMEs assess WHETHER you've retained that knowledge

• Your First Aid highlights guide what to review between NBMEs

When you get an NBME question wrong:

1. Find it in First Aid

2. If it's already highlighted, you need to review that section more carefully

3. If it's not highlighted, add the highlight — this is a tested concept you missed during UWorld

The systems work together. UWorld builds your knowledge. NBMEs test it. First Aid is the constant reference connecting everything.

The Numbers

Total UWorld questions: ~3,800

Questions per day: 40-50

Days to complete first pass: ~80-90 days (aligned with your 12-week base building)

Time per block (40 Qs + review): ~2 hours

Daily time for UWorld: 2-3 hours

This fits within your 5-6 hour daily study commitment, leaving time for First Aid reading, Sketchy review, and other activities.

The Bottom Line

UWorld is a learning tool, not an assessment tool.

Your initial scores don't matter. Your final scores within each system do.

The method:

1. Tutor mode, system-wise

2. Wrong questions: read explanation, highlight First Aid, move on

3. Lucky correct: treat as wrong

4. True correct: quick read, move on

5. Complete 100% of each system

6. Last 2 blocks must be above 60%

Follow this method, and UWorld transforms from an overwhelming question bank into a systematic learning engine that directly prepares you for Step 1.

What's Next

You now know how to use UWorld during base building.

Next, I'll show you how to take NBMEs — the offline method with 40 questions per block, the three-timer system, and why doing NBMEs online is a mistake.

Then we'll cover:

• How to review NBMEs and actually improve (the notebook system)

• The 5 biggest mistakes IMGs make

• What to do when scores plateau

• Exam day strategy

UWorld builds your knowledge. NBMEs test it. Let's make sure you're testing correctly.

If you want personalized guidance on your UWorld performance — someone reviewing your scores, adjusting your approach, keeping you accountable — https://meetings-na2.hubspot.com/marish

Let's turn those questions into a passing score.

Dr. Marish Asudani Co-Founder, P2A Consultancy PGY-1 Internal Medicine | USMLE Mentor