Most people treat an SBA paper like a quiz. High scorers treat it like a system: minimise time sinks, standardise decisions, and turn the paper into a high-quality dataset for targeted revision. Your goal is not perfection — it is to maximise correct answers per minute, without triggering avoidable errors.
Why two-pass works
Two-pass strategies reduce opportunity cost: you bank the ‘fast marks’ first, then invest time only where it changes the outcome. This matches what we know from test-enhanced learning: repeated retrieval (attempt → feedback → re-attempt) builds durable recall more reliably than passive review.
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Step 1 — Decide your paper budget (before you revise a thing)
Write down the exam structure and do the arithmetic. PLAB 1 is 180 SBA questions in 3 hours. The UK Medical School AKT is two 100-item SBA papers on sequential days. Convert this into a target seconds-per-question so you have a real pacing rule, not vibes.
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Step 2 — Pass 1 = bankable marks only (no heroics)
On Pass 1 you answer only if you can decide within your pacing budget. If you cannot, you flag and move. This is not “giving up”; it is protecting your future self from spending 3 minutes to maybe gain 1 mark while losing 4 easy marks later.
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Step 3 — Flag taxonomy (so your second pass is efficient)
Use three flag types: (A) “I know this but need 20 seconds”, (B) “I’m between 2 options”, (C) “I’m lost / needs re-learning”. On Pass 2 you do A then B. C becomes your error-log work after the exam — not during it.
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Step 4 — Second-pass decision rule (kill 50/50 misery)
When stuck between two options, force a discriminating feature: what single detail would make one answer clearly wrong? If you can’t name that feature, you are guessing; guess fast, commit, move. Slow guessing is the most expensive behaviour in exams.
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Step 5 — Post-paper loop (where your score actually improves)
Within 24 hours, review only flagged questions and misses. Write one line: (1) cue I missed, (2) discriminating feature, (3) the rule I will apply next time. That becomes your spaced retrieval prompt for the next 7–14 days.
SourceGMC: A guide to the PLAB test (PLAB 1 format)
Open Link SourceMedical Schools Council: MS AKT Student Handbook 2026 (AKT format)
Open Link SourceRoediger & Karpicke (2006): Test-enhanced learning (PubMed)
Open Link SourceDunlosky et al. (2013): Evidence review of study techniques (PubMed)
Open Link