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USMLE Exams and the Importance of Biostatistics

Medical students in the US, particularly IMGs (International Medical Graduates) and pre-IMGs, know the importance of achieving a first time pass and high score on the USMLE (United States Medical Licensing Examination) Step 1. It is long and intense and everyone is always happy when it is finally over. The majority of the questions come from the section “Internal Medicine” so it would seem like an easy way to get a high score is to make sure you memorize everything internal medicine. In practice this is difficult because internal medicine is a gateway to many different topics such as nephrology, cardiology, pulmonology which makes it difficult to fully memorize. I would suggest first to learn the six disciplines as best as you can, but also know a few smaller sections very well. In this post I want to focus on the neglected discipline of medicine: statistics.

Before I dive right into the main part of this post, I wanted to introduce a bit of my background prior starting medical school. Many years ago I realized I wanted to become a doctor and I started working my way down the path of science. I had, and still have, a great love of math and science which propelled me to major in biochemistry. After one year I found the course load of biochemistry to be not socially isolating enough and added a math minor. This is where my passion for math started to grow. It is a very great tool for science, but now I see many medical students and doctors do not fully understand statistics.

Statistics is a branch of math, so most people would normally choose swallowing a pack of batteries than try to learn it. The most common thing I hear people say is, “Why do I need to learn this? I am not going into research!” This may be true, but you do have to read journal papers, understand them, and critique them. Statistics helps you decide if there are any sources of bias and evaluate the likelihood of a type I error (rejecting the null hypothesis when it is actually true) without even having any knowledge of the medical content of the paper. This will come into play in rotations and will continue throughout your medical career.

If gaining valuable critiquing skills for journal articles is not enough for you then I will give you a very strong reason. You will have biostatistics questions on the USMLE Step 1 and Step 2 CK exams. There will be several of them. On an exam of 322 questions you cannot afford to lose four to five guaranteed marks. A few of these questions will center on tiny articles you have to read, while others will be straight forward providing that you study for this.

I guess I did say that many people find studying for biostatistics about as exciting as watching paint dry, so is there an easy way to learn the material? Of course there is! I would not have written this article otherwise. I have an interactive e-book out complete with USMLE and MCCEE style practice questions. It makes the process much less painful and is more effective at helping you remember the content. I have shown a couple of example pages and a question below. The bold text is the answers to the blanks which is the interactive component.

Effect modification explaination
Number needed to treat/harm from textbook

  1. According to a shingles prevention study the live attenuated Herpes zoster vaccine decreased the incidence of shingles over a three year period by 50% in an at risk group. The difference was 3.3% for the placebo group and 1.6% for the treatment group. How many people need to receive treatment in order for one person to not get shingles?

  2. 1

  3. 43

  4. 2

  5. 59

  6. 14

Explaination for Number Needed to Treat question

You do not have to just take my word for it you can check out the reviews on Amazon at

That is all for this post, so if you want a free and non-obligatory consult on how to study for the USMLE, NBME exams, or MCCEE or any other medical exam check out and send me an email! If you liked this article just say so in the comments below!

Interactive biostatistics book for medical school
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