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How to conquer USMLE STEP 1

Updated: Mar 7, 2021

The dreaded STEP 1 has arrived.. But at least that means you’re nearly halfway through medical school, right?!


We will start off with the disclaimer that everyone has their own way of approaching this exam. Also, we took STEP 1 at a time when it was not pass/fail so keep that in mind. Nevertheless, there are a few resources that almost all medical students use to study for STEP 1 (none of these are sponsored). These include the famous UFAPS: Uworld, FirstAid, Pathoma, and Sketchy. If you master these resources, you will give yourself a great knowledge base for the exam.


Your medical school will most likely determine when you will take STEP 1. Our school required that we take it by late June, before we started our third year. With this timeline, we started studying in January, giving ourselves roughly 6 months to slowly start studying for the exam. We felt like this gave us adequate time to prepare without feeling too burnt out by the end. We would recommend that you do the same so that you are at your best when you take the exam.


We’ll be honest, this season of medical school is challenging. You will have to balance studying for your classes with STEP studying and any other extracurriculars that you participate in. But, you can do it!


Get organized

We created a calendar adapted from one given to us by an upperclassman (shout out to P.L.K.!) that helped us keep our studying on track. Without a calendar or schedule to ensure you cover each topic adequately, it can be very difficult to stay focused and the amount of material can be overwhelming. We mapped out each week by organ system and each day by topic, giving ourselves roughly a week or two to cover each system. Procrastination is the enemy here...unfortunately there is just too much material to play catch up if you get too behind. We will attach a sample of our STEP 1 study schedule to this post for you to adapt for your purposes.


Study strategies

Again, many people approach this exam differently so we will discuss what worked well for us. This by no means has to be the way that you study and we encourage you to make your own study method and hopefully adapt from what we did!


As we mentioned above, we created a calendar outlining when we covered specific organ systems. When working through an organ system, we covered each topic fully with the relevant anatomy, physiology, pharmacology, and microbiology and used FirstAid as our backbone. Most importantly, we would do Uworld every day, starting out with about 20 questions per day and slowly working up to what we could handle (usually 2 blocks of 40 per day). We found Boards & Beyond to be helpful for anatomy/physiology, SketchyPharm for pharmacology, and SketchyMicro for microbiology. We also set aside time every day to watch SketchyMicro and SketchyPharm videos (whether they were relevant to the topic or not) to make sure that we got through them all at least once or twice.


Make sure to do at least one full pass of Uworld. If possible, try to get through some of your missed questions as well. Take Uworld questions in timed, random mode as 40 question blocks. This is very important! If you do tutor mode, you will not get used to the timed element of the test and it can slowly start to creep up on you when the test rolls around. Even if you feel like doing Uworld by organ systems, we would recommend doing it random so that you aren’t biased when approaching the questions by knowing it’s about a certain organ system. This can help you review other topics at the same time. If you do this method from the start you will be glad you did!


Do as many practice exams as possible! There’s no better way to see how you’re doing than by taking practice exams. The Uworld assessments are very accurate so we recommend saving those for closer to the real exam. There are plenty of NBME exams that you can pay for online that can help you assess your progress. The calendar we provided gives an example timeline of when you can take each exam and which ones are more difficult. One caveat in regards to practice exams: The NBME exams can give somewhat inaccurate predictions of what you may score on the real exam (some over-predict, some under-predict). Therefore, be sure to use them as a resource, but do not obsess too much about the NBME test scores themselves. Uworld is a much more accurate predictor. If you have access to a full length practice test, we would recommend taking at least one to get accustomed to the timing. Otherwise, you can always just add 4 extra Uworld blocks to a regular practice test.


Don’t forget about biostats! Yes we all hate it but unfortunately it is very well represented on the exam. We recommend buying the Uworld biostats review since it is very comprehensive and relatively inexpensive. There are also many videos on YouTube that are useful.


Remember to set aside time for non-organ systems including pharmacology, microbiology, etc. Luckily, if you’ve been doing SketchyPharm and SketchyMicro you should be well prepared but remember to look through FirstAid to make sure every topic is covered.

Stay focused

With the 8-12+ hour study days it can be very difficult to stay focused. Realize that you will have good and bad study days and that’s okay. Turn off your phone and limit social media use! We found using a study timer (Google this) to be very helpful and we would typically study for 50 mins at a time and then take a 10 minute break. Once you’ve made it through a few cycles of this, you can take a longer break. This way, you won’t find your mind wandering and become too fatigued to be productive.


Don’t compare yourself to others

Easier said than done...One of the most challenging parts of this process is not comparing yourself to others. Even though we would put “blinders” on when we went to class and avoid talking about STEP 1 with our classmates, it’s inevitable to overhear people talking about their study techniques. If you are seeing good, steady progress with your study strategy and are doing well on your practice tests, keep doing what you’re doing! Just because someone else is doing something different, doesn’t mean you are doing it wrong. That being said, if you aren’t seeing good progress or feel that you’re studying isn’t working well for you, don’t be afraid to adjust your strategy along the way. This is not a static process and we can always improve!


Take care of yourself

Make sure to take care of yourself to stay sane! Exercise or take walks to break up the day, watch your favorite show, visit a coffee shop, or devote a little time to your hobbies. Get outside! Meal prep healthy meals and make sure to get plenty of sleep. Balance is key! If you are burnt out then you won’t perform at your best. It’s hard not to isolate yourself but make sure to see and talk to other humans too! Remember: it's a marathon not a sprint.


Study hard, do your best, and stay sane! Good luck!


--C&W


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