How to Study For Your Internal Medicine Rotation

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How do you study for your internal medicine rotation? There’s much to know and too little time. How are you expected to get through the 1000+ questions in UWORLD? How can you balance the studying while still doing well in the rotation?

In this post, I will go over my study schedule for the internal medicine rotation.

I will refer to my previous posts about resources and tips for the internal medicine rotation as well.

Spoiler alert, it’s doable. You can achieve honors on the shelf and rotation if you plan correctly.

Internal Medicine Rotation Week 1:


Your first objective should be to begin UWORLD as soon as possible. As of this writing, there are close to 1400 internal medicine questions. It’s a marathon getting through it and at times it feels like studying for Step 1 again.

If you have a typical 8-12 week internal medicine rotation, your goal should be to finish all questions by the end of week 5.

This averages out to about 40 questions a day. I wish it was less but there’s no getting around that number.

In fact, I recommend raising that number to 60-80 on days you have a half day or full day off. This will help keep you on track even if you skip a day or two.

There were days I came home and wanted to do nothing except sleep. Doing extra questions on my “lighter” days helped prevent digging too deep a hole.

So goal number 1 (and can be your only goal) is to finish 40 questions of UWORLD every day.

Do this in random tutor mode. Learn from all the questions, not just the ones you get wrong. The explanations is where the money lies. This will make the difference between doing well on the shelf and be barely passing.

If you get a question wrong, make sure you mark it. If you get a question correct but realize it was a lucky guess or incorrect reasoning, mark it. We will come back to these questions again.

.Hope you’re still with me.

Begin Anki

The second resource I recommended in my resource post in internal medicine was Anki flashcards.

There are about 2400 flashcards in this deck. Yes that’s a lot but you don’t have to finish them all.

Instead, use these cards as a way to constantly test yourself with small bits of info at a time.

I recommend doing 50 flashcards a day. Ideally, you can get 5-10 cards done during a downtime. For example, I would use my walk into the hospital as an opportunity to begin. I would often finish the rest during the lunch lecture for the day.

Use Anki to develop your base of knowledge. The cards in my Anki deck included high-yield bits of information. They were terrific whenever I didn’t have enough energy to do UWORLD questions.

Begin Skimming Your Text:

Step-up to medicine 6th ed

I used Step Up To Medicine as my text of choice. You can learn more about the book in my recommended resource post for the internal medicine rotation. Check out the book here. 

The book has 12 chapters and about 500 pages. That’s a lot and honestly more than you need to excel on the shelf.

Instead, begin skimming the chapters. Aim to pass through the entire book once by the end of Week 3.

Skimming 20 pages in the book shouldn’t take more than 30 minutes a night. The point of the skim is to glance at topics you know well and instead dedicate more time to weaker material.

Internal Medicine Rotation Week 2-5:

By the end of week 5, you should have finished UWORLD once.

If you had a busy first couple of weeks, then readjust your schedule. Either do more questions per night or extend your deadline to complete UWORLD.

Once you finish all of the internal medicine questions, go back again but just do the marked questions. Divide however many questions you have by 21-24 days. This way you can complete your second round of UWORLD by the start/middle of week 8.

By the end of week 3-4, you likely finished skimming your text of choice. Now we’re going to pick what to read for the next three weeks strategically.

Look at your UWORLD scores and identify your struggling topics. Order the topics based on the percent correct you’re getting.

For example, you may be getting 75% of the cardio question correct, 45% of GI, and 55% of infectious disease. You would then first read about GI, then ID, and finally cardio.

Progress while studying and testing during the internal medicine rotaiton

This is what your grades will start to do with more practice questions during your internal medicine rotation!

Your reading can now be more directed this time around. You already know the subjects you’re not scoring well on. Thus spending reading and understanding these topics is worth the time.

But at the same time, avoid rereading through topics you’re scoring well on. It’s becomes diminishing returns to passively read about topics you’re scoring highly on.

Internal Medicine Rotation Week 5-7:

During these weeks you’re putting the final touches. You should be sharpening up your knowledge base by redoing your marked question on UWORLD. Also, you’re rereading the text based on your weakest topics.

Don’t forget to continue your Anki cards as well. Do these during downtime to quickly gain tiny bits of high-yield facts. The flashcards will help improve your UWORLD scores and thus your targeted reading.

Aim to have finished all the UWORLD questions by the end of week 7. Week 8 is meant only to test yourself.

Internal Medicine Rotation Week 8:

Studying during the internal medicine rotaiton

The home stretch. This week is all about testing and strategic learning.

If your test is on a Friday, then plan on doing 2-3 NBME exams by Thursday. Schedule the first on perhaps the Sunday/Monday and the second on Tuesday/Wednesday.

I prefer taking the test under self-paced conditions but pretending as if it was timed. 


The sad thing about the NBME exams is that you don’t know the correct answers. It just tells you which questions you missed.

But thankfully, med students love to post answers and explanations to NBME questions online. So I set my timer to 110 minutes and begin the test as if it was the real thing.

When the clock hits zero, I Google the answers to every question and try to understand the explanations. This is just as important for the correct questions as it is for the wrong ones.

Begin to make a list of weaker areas as you go through the test. For instance, you may have had a question about hepatitis you struggled with – write “Hepatitis” down on a scratch piece of paper.

By the end of your test, you’ll know what material you need to review. Go through your text of choice and read about these topics.

Make sure to take at least two, if not three, NBME exams. They’re helpful to determine how prepared you are and helps to familiarize yourself with the difficult of questioning. I found the NBME exams to be easier than UWORLD and equal in difficulty to the real thing.

Finally, take a look at the helpful review PowerPoint from UT San Antonio Health Science Center. You can find more about it in my recommend resource post for the internal medicine rotation here. Here’s a link to the review PowerPoint.

I found it helpful to review the PowerPoint 2-3 times. The first two passes were slow and methodical. The last pass was a quick skim through. It’s a great resource to compile all of the internal medicine rotation into a few high-yield slides.

The only thing left is to take that exam and kill it! Best of luck!

Hope you’ve enjoyed this post about how to study during the internal medicine rotation! Check out my recommended resources as well as tips for the IM rotation.

Whenever you’re ready, there are 4 ways I can help you:

1. The Med School Handbook:  Join thousands of other students who have taken advantage of the hundreds of FREE tips & strategies I wish I were given on the first day of medical school to crush it with less stress. 

2. The Med School BlueprintJoin the hundreds of students who have used our A-Z blueprint and playbook for EVERY phase of the medical journey so you can start to see grades like these. 

3. Med Ignite Study ProgramGet personalized help to create the perfect study system for yourself so you can see better grades ASAP on your medical journey & see results like these. 

4. Learn the one study strategy that saved my grades in medical school here (viewed by more than a million students like you). 

If you enjoyed this post then check out the following as well!

How to Study For Rotations In Medical School (Step-By-Step Method)

Top 7 Tips For Third Year Of Med School (How To Do Well)

Top Resources for Your Surgery Rotation

Top Tips to Honor Your Surgery Rotation

Best Way To Study For The Internal Medicine Shelf Exam

How to Find Time to Study During Clinical Years in Medical School

Top 12 Best Internal Medicine Books For Medical Students

Until next time, my friend…

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