Pacing & Endurance: Preparing for Success on Standardized Exams Stage 3 of 4
Before advancing to the next stage of test preparation, let’s reflect on the journey thus far. At the onset of this quest, your first stage was to arm yourself with sufficient knowledge by Capturing Core Concepts. Recall that the goal is not to memorize all the content or to reinforce all concepts equally. Instead, review of core concepts was to be completed with two missions in mind.
Your first mission: make sure that it makes sense.
Your second mission: reinforce weak points and high-yield topics.
At this point, I implored you to “rip off the band-aid and start taking some practice quizzes!” However, taking quizzes for a standardized exam is not the same as preparing for a typical academic exam. Implementing the process of Practice-Based Learning for stage 2 required a recalibration.
Your first mission: realign your expectations on what “successful” practice means.
Given that standardized exams are created to fit to a bell curve, the goal is for the average test taker (on their official exam) to score as close to 70% as possible. Therefore, practice scores leading up to this exam should be expected to fall in the 60s, 50s, and 40s.
Your second mission: compare the logical path outlined in each answer’s explanation to your question approach, identifying where you were on track and where you went astray.
During this stage, it is more important to focus on method over timing. Learn to develop your clinical reasoning pathways appropriately and allow efficiency to develop over time. A preemptive concern over timing creates heuristics based on what you know now, leading to an overdependence on buzzwords or a single detail to answer the question as quickly as possible.
I typically recommend somewhere between 1,000 – 2,000 practice questions be completed in study mode or untimed mode, but the key is when YOU are confident in your approach. Now you are ready to move onto the next phase…
Stage 3 – Pacing & Endurance
To mentally prepare yourself for the transition to “Timed Mode” in your question bank, you’ll first want to investigate your standardized examination. Even if you have done this previously, now is an excellent time to revisit the data.
Your first mission: set your Goal Score for Test Day.
For assistance on how on this process, see my recent article, Aim High, Score Higher: Planning for a Standardized Exam.
Your second mission: get used to the pacing with short quizzes first, then progressively lengthen them.
A key aspect to getting yourself up to speed with the pace needed for Test Day is not giving yourself a lot of wiggle room. Taking long quizzes in which you don’t get to and appropriately approach a large number of questions won’t apply the same pressure you’ll feel when attempting to complete 3-5 question quizzes within the time limit.
*Medical Students: As you complete these micro-quizzes and adjust towards the necessary timing, do not abandon the step-wise, clinical-oriented approach you’ve been developing towards cases.
Practice moving forward with your predictions more quickly and confidently; now is the appropriate time for making mistakes and learning from them. Waffling between answer choices and changing answer choices frequently will make it more difficult for future you to remember what you picked this time.
From here, expand the length of your timed quizzes as your comfort grows: 5→10→15→20→30→40.
Once you are comfortable with completing a full block/section of your standardized exam within the allotted time, your focus should next shift to building your endurance.
Your third mission: build the endurance to complete a full-length exam effectively.
To understand how to do this well, we need look no further than our marathon-running friends. Curious, I asked Chat-GPT, “How do marathon runners train for the necessary pacing and endurance before a big race?”
While I could interpret this for you, my dear reader, I would prefer to leave the analogy intact and allow you to extrapolate the conclusions for yourself. Here was the response:
Marathon runners employ a variety of structured training strategies to improve both their endurance and their ability to maintain an appropriate pace throughout 26.2 miles. While the specific approach can vary depending on the runner’s experience, fitness level, and goals, most successful programs share key elements designed to build aerobic capacity, develop a sense of pacing, and prepare both mind and body for race day demands.
1. Gradual Mileage Progression: To build endurance, runners steadily increase their weekly mileage over several months. Initially, this may involve frequent, shorter runs at an easy effort to create a strong aerobic base. As training progresses, weekly mileage and long-run distance incrementally increase, allowing the body’s musculoskeletal and cardiovascular systems to adapt without undue stress or injury.
2. The Weekly Long Run: The cornerstone of any marathon program is the long run—an outing that gradually extends from a comfortable distance to up to 18–22 miles. These runs train the body to efficiently use energy stores, improve fat-burning capacity, and develop mental resilience. Long runs often start at a very easy pace to emphasize endurance over speed, and some may include segments at the intended marathon pace as race day nears.
3. Incorporating Race-Pace Segments: To get comfortable holding the target marathon pace for extended periods, runners periodically incorporate marathon-pace miles into their training. For example, they might run the first half of a long run at an easy pace, then transition to marathon pace for the final segments. This approach conditions the runner’s cardiovascular system and muscles to sustain the goal rhythm even when fatigue sets in.
4. Tempo and Threshold Runs: Tempo runs—sustained efforts at a pace just below the lactate threshold—help improve a runner’s ability to hold faster speeds for longer. By consistently challenging the body at a pace that’s comfortably hard but not all-out, runners increase their lactate threshold, enhance running economy, and develop the confidence to maintain a steady, challenging pace.
5. Interval and Fartlek Sessions: While less focused on marathon pace itself, shorter, faster workouts (like intervals on a track or structured fartlek sessions) improve running economy, turnover, and overall aerobic power. By training at higher intensities, runners become more efficient at all paces and often find maintaining marathon pace feels easier over time.
6. Pacing Practice in Tune-Up Races: Running shorter races—such as a half marathon or a 10K—at various points in the training cycle provides valuable pacing feedback. These tune-up races simulate the pressure and excitement of race day and help refine the runner’s intuitive sense of pacing. Post-race analysis of splits and effort level guides adjustments to training and pacing strategy.
7. Fueling and Hydration Strategies: Holding pace over many miles isn’t purely about fitness; proper fueling and hydration are essential. During training, runners experiment with various sports drinks, gels, and timing of fluid intake to ensure steady energy availability. Learning to fuel regularly during long runs helps maintain a more consistent pace and delays fatigue on race day.
8. Strength and Form Work: Improving running form and muscular strength supports efficient pacing. Many runners include core work, hip strengthening, and balance exercises in their routines, along with occasional strides or hill sprints. Over time, improved biomechanics and posture make it easier to hold a steady, even pace.
9. Recovery and Rest: Adequate sleep, proper nutrition, and low-intensity recovery runs help the body adapt to the stresses of training. When well-rested and recovered, runners can hit their target paces more consistently and safely increase their endurance.
10. Mental Rehearsal and Goal Setting: Training also involves mental preparation—visualizing the race, practicing even splits, and setting realistic pace goals based on past performances and training data. A clear, practiced pacing strategy can help mitigate the common urge to start too fast and improve the odds of finishing strong.
By steadily building mileage, practicing race-pace running, experimenting with speed sessions, and refining fueling strategies, marathon runners develop both the physical endurance and pacing proficiency required to perform optimally on race day.
I hope you found the structure of today’s article interesting, along with the integration of my writing with a clearly delineated AI-advice portion. The remainder of the article was written without AI involvement.
Join me next month for the final article in this series, Block & Full-Length Strategies.
