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Medical students who start out scoring low on USMLE practices tests aren't doing so because they're "unintelligent". Rather, some of the most intelligent students simply have cognitive tendencies that are less suited to standardized testing.
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These students may hone in on subtitles, and focus more on possibilities than concrete answers, or may be uncomfortable guessing or using process of elimination because they feel they have to obtain a comprehensive understanding of each question. These students can be taught to approach questions in a way that is more likely to get them points, and this approach is specific to the particular exam different even for Step 1 vs.
Step 2 CK. For exams that are so content based like the USMLE, high scores are clearly not about pure intelligence; you have to study efficiently or study a crazy long time! Many students study in ways that may lead to success in medical school courses, but are not very efficient for the USMLE. This is because the way most people have been taught to learn in school is ineffective from the point of standardized test taking. Students often try to learn too holistically and attempt to learn more than is needed to get points feeling they must understand everything , which leads to greater cognitive fatigue and poorer recall on test day.
You need a well-integrated, comprehensive body of knowledge to practice medicine, but not to ace the USMLE.
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A Structured Study Schedule is Key. Some students also struggle with motivation and staying on schedule to a degree that might surprise those who assume all medical students are highly efficient workaholics. As a tutor, I actually make hour-by-hour schedules for every day for my students that I adjust weekly. Many students find this really helpful to stay motivated and on track, and quickly realize they haven't been getting as much work done as they thought they were.
It's surprisingly easy to be working hard studying in the library for 14 hours a day without actually learning all that much, especially for those who are very hard working by nature. Systematic Errors and Poor Performance.