Peer Reviewed Exam Practice (PREP) is a student-led method for creating review questions aligned to content of the neurological disorders block at The Ohio State University College of Medicine; a 7-week course consisting of neuroanatomy, neuroscience, clinical neurology, ophthalmology and psychiatry. A team of 5 students wrote 5 multiple choice questions each day that covered presented material. Questions included detailed rationale and citation from curriculum content. Questions were internally peer-review and provided to course faculty for editing and feedback. They were distributed in a series of quizzes and a practice exam. When students completed questions, correct response and rationale were immediately available for review. Students rated question difficulty on a 1-10 scale with 5 anchored as “appropriate difficulty.”