Whether you are well prepared for the exam or not, The following steps may help you enhance your score. Please pick and choose what you like or do just as outlined here.

Study in advance for the exam - of course - great advice!!! If you have prepared well in advance, do not read ahead at all what is written on this page. NOOOO... - even you may benefit from what is here.

Please know the level of your exam. Do not over-prepare nor under prepare. Do not try to know details that are unlikely to appear in the test. I remember that for one of the exams taken earlier in my career, I had quite strongly tried to learn all of Harrisson’s. I almost knew it all but did badly in my exam. Of course I abandoned that strategy.

Please buy books that focus on the exam.

Be dressed to encounter a cold room as you can always take some layers off but if you do not have the clothes, you will be freezing throughout.

Make sure you have your exam ID and other forms of photo ID required for the tests ready at least 2 nights before the test (because you do not want to be searching for the stuff on the day of the test - nor do you want to be searching for it one night before the test or else you may not sleep well on the night before the test).

Keep your pencils/pens ready, preferably at least one day before the exam date - For ABIM takers (since USMLE has now become completely computer based).

Do not forget the eraser. (In many countries it is called a rubber!)

Keep some cash handy. Credit cards are good but cash is always faster and definitely accepted

If you have some traveling to do, ensure that you have adequate time for a mishap like a train delay/car breakdown.

If you have a long drive to the exam center, please try and stay in a hotel very close to the exam center. This will give you a fresher feeling as you answer the questions.

Do not use sleeping pills or other medicines that you do not usually take before the exam day. I have no opinion about NODOs but certainly want you to have a good night’s sleep before the exam day.

Continue to prepare – even until the last minute.

Do not discuss stuff before the exam with other candidates you may meet outside the exam center. It creates unnecessary anxiety.

It has been shown in children that those who ate a high carbohydrate meal just before the exam, do better in the test than those who did not. I see no reason why it will harm an adult to do the same.

Do not chew candy or gum. This adds an extra distracter at a time when you should be totally focused on just the questions.

Once the exam starts, if you notice that the exam booklet has been opened by the other candidates and you are still writing down your ID and name etc., please consider to pursue with the exam as at the end, the examiner is more likely to let you write your name rather than allow you to answer questions.

For ABIM, count the exam questions and divide the number of questions into four equal blocks. Divide the total time allowed to answer them into 5 blocks. In each time block, try to complete one block of test questions. At the end you will thus have one block of time left for revisions. Also remember that at the end of the test, ones pace slows down thus it is very important to allow extra time at the end.

In the examination, if you feel like using the restroom/toilet, please do so, as you will be able to answer much faster once you are relieved. I have personally tested it out, as have some of my friends. Certainly – if you have only 2 minutes or so left, please stick around to answer the exam (obviously!)

If your seat is uncomfortable, (once in an exam I had a seat that was just rocking and knocking – I requested a change immediately – and was accommodated) please get it swapped.

If your neighbor is too noisy, tell the examiner (proctor) that it is distracting and have him/her sort it out.

Some exams allow you to come back and answer the question. Others do not. Some divide the exam into blocks/sections and you can return to unanswered questions in a block only if you have not completed the block completely. If you are allowed to come back and answer, mark each question that you do not know the answer to but please choose an answer before you go on and mark the choices you have eliminated. You may find time to come back to it. Marking the choices eliminated will save you time the second time around.

As you read each question, you may find the answer to another question that was there before in the same test. Do not go searching for the previous question at this stage if you think you need to change the answer on that one. Just mark this current question in a different way from the questions that you do not know answers to and come back to it later on – just like you would for the ones you did not know the answers to. This does not waste your precious time in which you could go ahead and answer a lot of questions.

Avoid cheating. It adds unnecessary stress during the exam. I remember one of my friend taking a piece of his notes to an English test. He said that he could not open the notes and could not answer the test comfortably as he had the stress of having this illegal material with him. Eventually, he passed off the notes to someone who asked for them and after that, could write properly.

You do not have to be helpful to anyone during an exam. Your time is precious. I realize that most of us are good hearted – but do not lose your own time for someone who did not prepare and is now disturbing you during the test.

It is unfortunate but the meanest and most ungrateful people do well in exams that are LOCAL. In national level exams, you do not lose anything by being nice. This happens because local exams have little competition and depriving your friend of some crucial info may help you -–but for national level tests, there are so many people competing that your best bet is to join hands and prepare.