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.

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.
uworld excel.JPG
This is how my excel notes looked like. The page numbers and question numbers are made up.
  • 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)

step 1 month.JPG
Example schedule. I would dedicate 1 day to a particular topic. Sunday’s were for NBME exams. Saturdays were much lighter (2-4 hours max for studying). I thought this type of template allowed me enough room for flexibility and last-minute changes.
step 1 daily.JPG
Example daily routine: I tried to start qbanks at the same time I started the actual 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).


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

5 Thoughts

  1. Thank you for this post! I am in the process of getting my study schedule and resources together for studying for Step and this post really helped me! I was going to use those same resources but couldn’t figure out exactly how to organize my study schedule. Thanks so much! (:


  2. Thank you so much for this post! It’s been so hard to decide on a study plan & I love having something that lays it out for me. I love the idea of keeping track of the questions in Excel. I just have 1 question.. how did you utilize the excel sheet during your dedicated study period? I see that you said you would review the Qbank, but I assume you’re referring to reviewing the questions from your 2nd pass through UWORLD and/or Kaplan.


    1. Hello! To answer your question, I printed it out into a packet. During my second pass, I would refer to my packet for missed questions. If I got a question wrong AGAIN, I would highlight it or something to remind myself to review concept again (since it didn’t stick the first time)


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