At least for the computerized portions (Step 1 and Step 2 CK):

• Practice, practice, practice. I used Kaplan’s Qbank for Step 1 and USMLEWorld.com for Step 2 CK. Half of the difficulty of the exam is being able to sit down at a computer screen and concentrate for 9 hours, and a quarter of it is knowing how to handle questions to which you have no freaking clue what the answer is. This is the big benefit of practice question services (also, it’s easier to make yourself go through another set of questions than to stare at a book again).
• Categorize and conquer! Get used to eliminating answer choices; get used to guessing between two or three possible right answers and moving on.
  I divide questions into three groups:
  a) those I know that I know the answer (answer and move on),
  b) those that I know I’m not sure about (answer and mark to go back to later), and
  c) those I know that I don’t have a clue what the answer is (answer and move on).
  There’s absolutely no point in stressing or wasting your precious minutes on categories a or c. If you know it, great. If it’s some ridiculous question that you’ll never know, and you can barely even eliminate any answer choices, don’t pull your hair and stress. That is letting the exam get the best of you. Take your best guess (usually your first instinct) and move on.
  Once you’ve gone through all the questions for a block, if you have time, go back and confirm/review category b. The key is to keep moving! You can easily freak yourself out by one tough question, when it’s more important to spend your time on questions you could possibly get right!
• Read the last sentence first. Maybe 10% of the time, you’ll get a question with a long, drawn-out paragraph about some patient, but then the question they’re asking is only tangentially related. For example, “Susie takes lithium. She has had bipolar disorder for 3 years now, she has a history of hypertension BLAH BLAH BLAH… What is a common side effect of lithium?” So you’ve just spent a good 30 seconds reading about Susie, when Susie doesn’t matter to the question, only lithium does. By reading the question ahead of time, you’ll also be able to focus in on what they want you to answer while you read the vignette–diagnosis, treatment, pharmacology, pathophysiology, etc.
• Keep track of what block you’re on. You’ll get a dry erase marker and two sheets of laminated paper to scribble on. Write down which block you’re on–it’ll help motivate you toward the end of the test and help you see there’s light at the end of the tunnel.
• Take breaks when you want, there’s plenty of time. You get something like an hour for breaks throughout the day. It’s plenty of time. If you’re thirsty, finish your block and get some water. Need to rest or pee? Go for it. They allot 30 minutes for lunch, but if you bring your own, you’ll eat it fairly quickly due to your nerves–and you’ll want to just get done. There’s plenty of time. (Plus, if you finish a block early, or get through the “Training” session early, those times get added to your break time, too.)
• Breathe. It will all be okay.

Any other tips people have used?

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