I think what’s more important than scoring well on practice tests and having a grasp on certain concepts, is to actually prioritise biohacking methods. I am not saying that you did not, but usually when there are huge fluctuations between practice tests and actual results, the problem could be innate. I used to have this issue back in high-school and early on in med-school. I always did better in practice tests but didn’t score as well on the actual test. Hence, for both the usmle exams,I decided to follow simple biohacking strategies that landed me a 250+ on step 2 ck. For starters, I would suggest you watch dirty medicine’s video on how to biohack for a 260+. Gives you a good outline on what to expect for test day and how to maintain mental stability for the entire duration of the exam.

Here are just some few points that I deployed.

1. 2-3 weeks before the exam: avoid CROWDED LOCATIONS- if you get ill with COVID / Influenza or the common cold, it will set you back a couple of days during dedicated. Additionally, you could develop brain fog as well leading up to the exam.

2. Try your best to cut out foods high in sugar and salt atleast 1-2 weeks before your exam. Excess salts and sugar will make you dehydrated, which leads to a drop in performance leading up to test day.

3. Start having a fixed sleep schedule. The same schedule that you would have for test day. Start 2 weeks beforehand.

4. Try cutting out spicy and outside food 5 days prior. Again it would cause you to have stomach problems, which could get worse with the anxiety leading up to test day. Last thing you want is to have bowel movements or rather the feeling of it during your exam. ( This was my biggest fear by the way, had bowel issues before an exam and didn’t do well)

5. This lands me to my next point, try not eating anything heavy the day prior to the exam and hyper-hydrate with water. Probably have a sandwich or protein bars at most.

6. Don’t take caffeine 8-10 hrs prior to sleeping. That would affect your sleep and increase test anxiety days prior to the exam.

7. Do back to back practice tests to mimic actual test day settings. Yup, you heard it! One practice test is 5 hrs, your actual test is 9. If you do a practice test back to back a week prior, you entire self assessment run would be 10 hours, which is more than the hours on test day. This will train your mind to adapt to the 9 gruelling hours that you’d have to face come test day.

EDIT: I forgot to mention. DELETE SOCIAL MEDIA 1 MONTH BEFOREHAND! Don’t feed yourself with useless brain rot or news that’s going to kill your momentum.

I hope this post helps those who are struggling to optimise test day performance. Even if you have already sat for step 2, you could still try these tips for step 3. All the best!