How to Study for the Step 1 USMLE Exam

DISCLAIMER: There are MANY study guides out there for taking Step 1, so this is by no means the ULTIMATE GUIDE and obviously might not work for everyone. Be sure to check out my medical school survival guide and my tips for studying effectively for additional study and exam resources.

UPDATE (3.29.2019): Textbook links updated!

I took my Step 1 exam in June of my second year of med school, at the end of my two preclinical years. I started lightly preparing in January (~6 months before). I wanted to enjoy the first half of second-year and also my last winter break thoroughly to prevent burn-out. For me, that was SUBSTANTIAL time, but I also kept up with schoolwork and studied for my classes.

There is the 6-month marathon, which is consistent weekly studying. And then the 1-month DEDICATED study period. Which is a daily REGIMEN.

6 months (24 weeks) until exam:

• Buy UWORLD. Start doing question blocks (46 questions) x 3 times a week (138 questions per week) in either the topics you’ve covered in class or are currently covering. Untimed.
  • I wanted to finish the >2400 questions ~1 month before my exam so I could go over it again. If you start earlier, you can do less questions per week. 
  • I started an excel spreadsheet for questions I got wrong/wanted to go back to, with my notes AND the page # where the information could be found in First Aid (FA). This is tedious but will pay-off during the dedicated study period.

• Start using Pathoma & First Aid along with your classes.
  • If I was doing renal, I would read through relevant sections in each book and lightly annotate and highlight sections. I wouldn’t really add extraneous info from classes into these books, BUT I would transfer information from UWORLD/Pathoma into First Aid.

3 months (12 weeks until exam)

• Continue with Pathoma, First Aid, UWORLD.
• Add second (or third) Qbank (depending on how ambitious you feel). Also add notes to excel sheet.
  • Rx
    • Pros: Helps you go through all of First Aid at least ONCE.
    • Cons: Much easier than actual exam.
  • Kaplan
    • Pros: Much harder than actual exam. Will help you think through umm#$%??? questions. Think Barron’s for AP books.
    • Cons: Lots of irrelevant/low-yield material.

1.5 months (6 weeks until exam)

• Take first NBME practice exam (out of 7 in total).
  • For us, this was offered by our school. I dreaded this day. But if your school doesn’t offer a mock exam, just sign up for one yourself. Take it in a mimic test setting (like your library, not your home). 
• Don’t let a low baseline score freak you out. I jumped 40 points in my last month!
• UWORLD: If you’ve been keeping up with x amount of questions/week, you should be almost done with 1st pass!
• First Aid/Pathoma: Go over sections not covered in class in your own time!
• Rx/Kaplan: Keep trucking.

DEDICATED 1 MONTH PERIOD (4-5 weeks until exam)

• Start 2nd pass of UWORLD. Continue with 2nd/3rd Qbank. Timed.
  • This is where your giant excel sheet you’ve been culminating for the past 6 months comes in handy. For every wrong question, FLAG/HIGHLIGHT the question in your spreadsheet. I literally printed out my excel sheet and turned it into a book for easy flipping. Don’t underestimate how long it takes to REVIEW Qbanks. That’s the bulk of your studying.
• Finish 1st pass of First Aid/Pathoma. Try to do 2nd pass if you can.
• Take one NBME exam each week.

Additional resources:

Neurology: High Yield Neuroanatomy
Microbiology: Sketchy Micro and Lippincott’s Microcards
Pharmacology: Lange Pharmcards
Everything else: YOUTUBE!! I loved Handwritten Tutorials.

1 week until exam

• • Take maybe one more NBME exam. Don’t psych yourself out too close to exam date.

• • Go over your Qbank excel spread sheet.

• Go over weak areas in First Aid/Pathoma.

Day before exam

• Some people study, others relax.
• Get up early so you can have a good night’s rest.

Day of exam

• Bring snacks and water! Granola bars, chocolate, nuts, etc to munch-on between breaks.
• Wear comfy clothing with NO or FEW pockets (to make security check quicker during your timed bathroom breaks).
• CRUSH THE EXAM.

Post-exam

• RELAX! CELEBRATE!
• Don’t think about the exam anymore. Everyone feels like they failed it.