I am uncomfortable bringing things up like this, but some struggling students may have a learning disorder or a personality disorder that needs medication or therapy to clear up. Seriously. If you are spending a long time studying but NOT ABSORBING, it is like a cup with a hole in the bottom. You are trying to fill the cup, but the "hole" is spilling out the information.
To retain the information, you may need medication. I say this to the students who cannot seem to gain traction and who cannot figure out their difficulty. I cannot say who would need medication or who would not, but it is worth looking at.
One such person was a lady who wrote that she was really really tired and having narcolepsy while studying. Another had ADHD, a learning disorder. For them, methylphenidate would be required. The student with the ADHD I heard went on to pass Step 1. Another had a serious ANXIETY disorder. Another had Major Depressive Disorder. Having such a problem WILL prevent a passing score.
Again, I am not trying to advocate drugs. But for some, it may be something worth looking at, under the strict guidance of your physician. Who knows, after you pass the Step 1 and practice, you may go on to treat others struggling with the Step 1 with your disorder and help THEM BECOME GREAT DOCTORS!
Cheers!
You can do it!
Tommyk