Learn how other students prepared for Step 1.

1) When did you start doing questions?

Student 1
“I started doing USMLE-Rx questions the summer between 1st and 2nd year just to “stay fresh” and review topics I found challenging during 1st year. I ended up buying the 6 month UWorld subscription and that was the perfect length of time to do UWorld 2x.”

Student 2
“I started over Christmas break. I personally wish I had started sooner. I think during GI/N, you should start doing 40 questions a day of REVIEW. I’m +/- on doing GI questions during GI. I think Uworld is such a good resource that I wouldn’t want to waste that first pass of Uworld questions when I don’t know the material at a Step 1 prep level.”

2) What advice do you have on setting daily/weekly goals?

Student 1
“I think setting weekly/monthly goals is a great idea for the fall semester. For example, you could plan to complete all of the cardio UWorld questions and FA before the cardio/heme NBME. These are realistic goals that can help you do well in your courses. As you approach winter break and step 1 I think a more structured plan is beneficial. From January to my step 1 date I had what topics and how many UWorld questions I was going to do planned out for every single day. This may be overboard for some people, but it reassured me to know that if I stayed on schedule I would have time to review everything I needed to.”

3) What advice do you have on having a written study plan?

Student 2
“So important. Start studying at least by R/R. Don’t be too ambitious. If you are too ambitious, you might fall into an all or nothing mindset. Make it doable, use Christmas to catch up. For dedicated, I bought a month of cramfighter and just used that. I didn’t want to fall into a trap of spending time making my schedule vs. studying. It is interactive and readjusts depending on what you get done or don’t on a given day. Would highly recommend.”

4) What advice do you have on having an accountability partner?

Student 1
“I didn’t have an accountability partner but I think it is definitely important to have people to talk to. We are all in the same boat so don’t be afraid to reach out to other people about the stress and pressure you are feeling. Everyone thinks they are “going to fail” and it is important to realize you are not alone in that feeling.”

Student 2
“I personally didn’t like doing this. I studied occasionally with friends, but being around other med students I found was too stressful. Don’t let other people psych you out. If you hear someone else using some different resource, don’t think you need to use it. Stick to what you KNOW works: First Aid + Pathoma + Sketchy + Uworld + Zanki +/- Boards and Beyond +/- Costanzo +/- Robbins. Learn these resources 100% of the way. Don’t spread yourself too thin. All the sources have the same info so just commit to a few and learn them COMPLETELY.”

5) How did you review topics from first year?

Student 1
“I think it is important to review 1st year topics early on during 2nd year. This will not only help you to do well in your other courses, but it will also give you a place to start with UWorld questions.”

Student 2
“Do all your zanki cards every day. That way you are reviewing old topics in with your new learning. This will make the associations automatic. This is the single best thing you can do for yourself.”

Student 3
“I know that the upcoming year seems really intimidating, but it will be an amazing experience. You will learn so much. At my peak my brain was able to bring up facts that I did not even know were in there. I know it’s cliché to say this, but you will all make it. It’s rough when you are going through it but when you look back on this experience you will be grateful for it. I just wanted to throw together some stuff based on my experience studying for Step 1.”

Disclaimer: “There are many ways to do well on Step 1 and this is just from my experience, observations, and the advice that I received from my mentors. I hate flashcards/space repetition things like Anki and Firecracker because I just don’t have the patience and focus for them. I am a huge fan of passive learning by listening/watching so my studying relied heavily on doing questions and watching Sketchy/Pathoma. If you learn better with spaced repetition, then you should include more Anki etc. and less Sketchy/Pathoma in your study schedule.”

Study Schedule and Resources: I can’t emphasize how important it is to not cheap out when you are studying. A couple hundred bucks on study materials is nothing compared to how expensive medical school is.

“The first thing to nail down is how you want to approach studying. The first part of this is when you want to start studying. There will be some people that start studying as early as August or as late as December/Winter Break. I personally was in between and started studying seriously in late September which gave me exactly 6 months to study (my exam date was March 31^st). The second part is knowing when you want to take your exam. Again, some people took their exam as early as mid-march (3 weeks into dedicated study time) whereas other people took it the last weekend before Transition 2. I gave myself a week off after my exam and the start of Transitions 2 and this is about what most people in my class did. If you are the type of person that can study really hard, be really focused, and put in long hours at the library every day, then you can probably get by with a more concise study schedule. I personally can’t do that, so I knew I needed to start early and take the exam later in March. If I were to go back and do this again, I would probably take the exam maybe 2 days earlier because I was really burnt out the last few days and wasn’t really studying that hard. I was probably losing knowledge at that point, but I would not take it any earlier than that.”

“The first thing I recommend is to find a secondary Qbank (in addition to Uworld) to use while you are studying for your courses. I would not recommend using Uworld to study for classes because the class exams and NBME finals are very different to the types of questions on Uworld. Many people use USMLERx or Kaplan Qbanks. The questions in these Qbanks are more in line with class exams and NBME finals. So, for every course starting with Cardio and Heme I did all the questions in the USMLERx question bank for whatever organ system we were doing. It really helps you learn the material and prepare for class exams.”

“Another resource I would highly recommend investing in is Cramfighter. It’s a website that takes all the stress out of scheduling. You basically just tell the website that I want to do x number of questions, watch these pathoma/sketchy videos, and read these chapters in First Aid. You tell the website how many hours a day you want to spend on it and how many weeks you want to give yourself to accomplish that and it spits out a schedule for you.”

“These are the core resources I used between late September and March and how I used them:

• Pathoma: In addition to watching it for classes, I probably watched it an additional 2 times and read the book 1-2 times between October and March. This is a great resource for foundational knowledge, especially when you have never seen the material before, but it is a bit overrated in my opinion. Once you start getting comfortable with the material, Pathoma doesn’t really teach you anything new. You need to know more than what’s in Pathoma.
• Sketchy Micro: Watched all of it twice and reviewed it once between October and March 31^st. Again, good foundation, but there will be some stuff that you need to know beyond Sketchy.
• Sketchy Pharm: This was the best way to learn pharm for me. It’s hard to remember all the sketches because the videos are so long but just listening to the videos was a lot better than doing flash cards and stuff. Again, I watched all of it twice and reviewed it once in addition to whatever I needed to watch for class.
• SketchyPath: This didn’t come out until like the winter right before our exam so I only watched it once in March. Pathoma is a good foundation but SketchyPath gives you that little bit extra. If you can find time for it, I would recommend watching it in conjunction with Pathoma throughout your classes. SketchyPath is more advanced than Pathoma so I would recommend watching it after Pathoma.
• First Aid: Use this as a reference. You are not expected to memorize FA from cover to cover. You will not get anything out of just reading it cover to cover. Reference it to brush up on topics you are unfamiliar with and for high yield review.
• Uworld: This is the Holy Grail. I did all the questions nearly 3 times. For every question, even the correct ones, review the explanations. This is the best way to study for Step 1. You are allowed to reset Uworld once per subscription, so I reset it after my first go around and during my second go around I marked all the questions I got right but wanted to do again. So, during my third go around I did all my incorrect and marked questions from my second pass again. Another approach is to start Uworld later, like in December/January, and do it twice in a more condensed time frame. You will have to do more questions a day, but you might retain more because you are doing them closer to your exam date. The biggest regret I have heard from people who did not do so well is that they wished they had finished going through UWorld at least once.
• Uworld practice exams: 2 exams, 160 questions each. Basically, more Uworld questions but in an exam format. The scoring system Uworld has for these exams is wacky and it supposedly overestimates your score by at least 10 points so use them just for practice and don’t put too much weight on the scores they spit out. However, some people’s scores do end up being similar to their Uworld scores.
• Step 1 NBME Practice Questions: These are a set of 120-130 questions that the NBME releases every year for free. What I would recommend is that you download the 2018 question set now before they release the 2019 question set because they will take down the 2018 question set when they post the 2019 question set. That way you have 2 sets. There will be a lot of overlap but some differences year to year. These questions are not really representative of the actual exam.
• NBME CBSSA exams: As of my writing of this document, there are 6 NBME exams available: Forms 13, 15, 16, 17, 18, and 19. Some of my classmates did not take all the NBME exams but I would highly recommend taking as many as possible because they are the best way to track your progress.”

“I split my studying into three blocks: October through the end of winter break, Spring semester through the first two weeks of designated (8 weeks), and designated study (3 weeks). This is what I did in each block:

• September through Winter Break: I broke my studying down by First Aid chapter. I read the chapter in First Aid, watched the associated Sketchy/Pathoma videos and did all the Uworld questions on that topic. Then I moved on to the next chapter. We obviously did not cover MSK, Derm, Repro, and Endo in class until after winter break but I went ahead and did those sections as well.
  • I went through all of Uworld: For every question I got wrong, I went to First Aid and highlighted that topic in yellow. If that topic was not explicitly in First Aid, I wrote it in and then highlighted. If I missed another question on the same topic, I highlighted in blue. And for a third strike I drew an asterisk next to it and so on and so forth. I did my questions untimed and in tutor mode in the first go around.
  • I watched all of sketchy pharm and micro once in this time (not including watching it for class). I took detailed notes on all the videos while I was watching to help me focus and to have notes as reference. This took a while.
  • I watched all of Pathoma once in this time as well (not including watching it for class).
  • In October the school will require you to take an NBME CBSSA exam. I took Form 13 early October. I took the first Uworld practice exam over winter break. For both exams go through all the questions. I also annotated First Aid with any questions I got wrong just like I did with Uworld.
• Spring semester through the first two weeks of designated.
  • I watched all of Sketchy Pharm, Micro and Pathoma again for a second time.
  • I reset my Uworld account and went through it a second time. This time I did not do the questions by subject. I did them completely randomly. I did a mix of untimed/tutor mode and timed blocks. I also continued to annotate First Aid like I explained. Finishing this took all of spring semester and the first two weeks of designated.
    1. I also started typing up the topics that I had missed twice or more onto a word document of “high yield review.” I copied pics and charts from the First Aid PDF when necessary.  I also included topics that I just needed to review more (like lysosomal storage diseases lol). This made reviewing these topics more efficient because I could just flip through a 20-25 page world document instead of first aid. I continued adding to this document through designated as well. I reviewed a few pages of this document everyday starting in designated.
  • At the beginning of the spring semester the school will administer a CBSE which is exactly the same thing as a CBSSA exam but is not available for you to take on their website, so you have to go into school to take it. I took NBME Form 15 a couple of weeks into the semester. I took NBME Form 16 the first week of designated and the second Uworld exam the second week of designated. I reviewed these exams, annotated first aid, and added to my high yield review word document.
• Last 3 weeks of designated (my exam was on a Saturday)
  • I read through my Sketchy Pharm and Micro notes that I took when I watched them in October through December. I read through all of Pathoma. I watched all of Sketchy Path for the first time.
  • I flipped through First Aid once or twice to read through things I highlighted and annotated.
  • For Uworld, I did all my incorrect and marked questions again (~2000 questions because I marked questions liberally). I continued to annotate First Aid and add to my high yield review document.
  • I had three more NBME exams so I did one of those each Monday.

Information about the exam: “It is really hard for most people to gauge how they did based on how they felt during/after the test. When I take tests, I mark any question that I have even the slightest doubt about. I was usually marking 12-16 questions on each block. That’s how bad you will feel. Be prepared for that, but don’t let that feeling defeat you. Since no one knows how they score Step 1, you can’t guess your score based on how many questions you think you got wrong. Additionally, there are a few “experimental questions” on the exam that are included to gather data, but not included in the final tally.

I know that wellness gets thrown around a lot in medical school but please remember to take care of yourself. Yes, you will have to make some sacrifices in your social life, hobbies, etc., but please remember to take care of yourself. Take some time every day to do things you enjoy doing, whether it’s working out, talking to a friend/significant other, watching TV, etc. Most importantly, take care of your body. Eat well, get enough sleep, and exercise. I was able to go to the gym 2-3 times a week most weeks and played intramural basketball in the fall and spring. I was also able to get 7-8 hours of sleep most nights during designated.”