When I was a third year medical student, figuring out how to study for shelf exams was always a topic of conversation. Prior to third year, due to the delivery of a consistent didactic curriculum, having a studying strategy was relatively easy.

Not so for third year, where almost all the learning is done in the wards. Figuring out how to study for the shelf exams at the end of rotations can be difficult — often times there isn’t a consistent didactic curriculum to help prepare for shelf exams, leading to much debate between medical students.

While med student’s might debate the different types of texts available to study for third and fourth year rotations, there is one text consistently mentioned during each of these debates — the “Pre-Test” series of question and answer books. Of note, these textbooks are valuable sources for USMLE Step 2 studying as well.

These books are essentially question banks, and in the case of Pre-Test Medicine, categorized by specialties, and containing detailed explanations of each multiple choice question.

Modality, recently bought by Epocrates, is the development company that has taken these McGraw-Hill textbooks and transferred nine of them to mobile app form. The transfer of a question bank to mobile form makes complete sense — you can use a timer, choose categories of custom questions, track how you are performing on questions, and many other levels of functionality that Modality brings in the app form.

However, we have some serious issues with the the Pretest series of apps, something we’ll discuss in this full review.

The eight McGraw-Hill text books that have been transferred to app form are: Pre-test USMLE review Medicine, Pre-test USMLE Review Surgery, Pre-Test USMLE Review Pediatrics, Pre-Test USMLE Review Emergency Medicine, Pre-Test USMLE Review Family Medicine, Pre-Test USMLE Review Psychology, Pre-Test USMLE Review Neurology, Pre-Test USMLE Review Obstetrics and Gynecology, Pre-Test Pathology USMLE Review.

Creating and taking a Quiz:

This section allows you to create a custom quiz, and you have the ability to access the quiz when you come back to the app as well. In the custom quiz you can decide exactly what category of sections you want to cover, e.g. Infectious Disease. You are also able to determine the number of questions and can bookmark questions throughout the quiz. You can only access the correct answers once you are done with the quiz — not exactly ideal when you only want to do questions in short bursts. When you start a quiz you are given an active timer in the upper right corner of the app.

Cumulative Stats:

Here you can see the breakdown of your scores by specialty type. (For reference sake I randomly answered a few questions)

Question Browser:

This is the section I used the most when I was on my medicine rotation. The whole point of having a mobile question bank is to utilize it in between cases and when there is some downtime between patient care. Using Quiz mode does not offer utility for this type of learning because you have to wait until you are completely done with a section to review your answers.

What I liked:

*Ability to create a custom quiz with time limit.
*Multiple choice questions with very detailed explanations.
*Ability to see your cumulative scores by categories.
*Quality of questions was solid — not necessarily what you will find with the USMLE, but the explanations allow for great USMLE learning.

What I didn’t like:

Lack of updates:

Only recently, March 1st of this year, were many of the Pretest series of apps updated by Modality. Until then, they had not been updated since August, 2009. Well over a year. Apple had added fast app switching,retina display, and many other key functionalities almost a year prior, yet only recently were you able to do fast app switching with these apps.

Fast app switching is essential because you need the ability to do question and answer sessions in 5 to 10 minute time intervals when on the wards. Doing a full quiz mode is not useful for this mobile form of learning. Since this app did not have “fast app switching” for over a year, using “Question Browser” mode was useless to me. Note, the app did allow you to restart unfinished quizzes, but again, the app is most useful in “Question Browser” mode.

If it took more than a year for Modality, a company who we are huge fans of, to update this venerable series of expensive apps, we question if it would take more than a year to add basic new functionality that Apple adds again in the future.

No iPad version??

It’s extremely easy for developers to scale their iPhone apps for iPads — why Modality has not done this for the Pre-Test series of apps is perplexing. I’ve attempted using the Pre-test series on my iPad with horrible results. The screen is pixilated and blurry when I maximize the screen since it has not been customized for the iPad. If anything, this app would have shined on the iPad.


Overall, the Pre-Test USMLE Question bank apps for the iPhone and iPod Touch are solid resources for medical students in their 3rd and 4th year for rotation exams and USMLE Step 2 board studying. However, as detailed above, we did have some issues with how the app is updated and the lack of an iPad version, and it should make users think twice before purchasing this series of apps.

It should be noted these dislikes can be easily remedied by the developers with minimal effort. Until then, we recommend this app with a great deal of caution, and you might be best suited to use the textbook version of the app.

iTunes Link to app: http://itunes.apple.com/us/app/pretest-medicine-usmle-review/id324302539?mt=8

Price: $29.99