How to study for USMLE STEP 1!

 

Hi guys, Emile here! So I took USMLE STEP 1 a little over a year ago and I wanted to share with you some my tips for success. I learned a lot along the course of my studying and I want to preface everything said below with this: This is simply one student’s approach to STEP 1 studying so please take everything I say with a grain of salt. If there are resources you loved and used over the course of M1/M2 year then use those instead. Some people love lectures, some love using primary texts, some love video based learning, and some love rapid firecracker questions, so go with what has worked with you in the past because it will probably work best as you go into STEP studying. Here are the important things I want to stress:

  1. Have a plan/schedule but expect it to change

Before you go into your STEP 1 cave, its important to have an idea of how you’re going to split your time. There is a lot of information to cover over the course of a few months and a lot of questions to cover, too. I used First Aid as my guide for disciplines and spent between half a week to one week for each discipline. I spent one week on Biochem, one week on path + immuno, 1 week on micro and 1 week on pharm to start. I then spent a half week to one week covering each organ system. This gave me a little over 3 months to cover everything and have a couple weeks at the end of our dedicated schedule to review  everything again. I didn’t plan each day out because I was never able to complete everything I thought I was going to so my schedule would have to be altered way too often. I gave myself general timelines for what I wanted to complete and it gave me a lot more flexibility.  Here is what a typical day looked like for me:

6:30-7 am- Breakfast + review Anki

7am-11 am- UWORLD (40 questions) + Review

11-1 pm- Lunch + Gym

1-4 pm- Review First Aid/Pathoma/Sketchy on whichever subject I was covering that week

4-6 pm- UWORLD (20 questions) + Review

6-7 pm- Review with classmate, quiz each other on concepts + Dinner

7- 10pm- Wind down and watch sketchy videos/ pathoma/ Anki questions until bed

 

2. Pick one question bank and one primary resource/text to use. Here is my step 1 cocktail:

 

 

UWORLD:

Everyone will tell you that UWorld is the main thing you will need to purchase for STEP 1 studying and they’re absolutely right. UWorld, in my opinion, is an incredible learning tool and a must for STEP 1 studying. Each question is filled with many learning topics and teaching points. They have amazing explanations and incredible charts, images, and diagrams that help things click really nicely. I will caution you to not get too caught up in your UWorld scores and instead focus on learning from them. Use your NBME practice exams as assessment tools, and simply learn from your UWorld questions (I realize this is easier said than done). If you come across questions that you know really well don’t waste time reading the entire explanation and just skip down to the learning objective. For questions that are really tough/topics that you’re weaker on- spend more time taking notes and go through each answer choice carefully. The way I organized the questions made the most sense to me- I would cover a topic and add check box to my UWorld question bank and as I went through my STEP studying I would continue to add topics as I went. For example, I would study heme-onc and check that box for systems as I did a UWorld set, then I would study cardio and as I studied that, I then added that to my UWorld set, and so on and so forth until I had checked all the boxes. I ended up completing the Q bank twice and I was glad I did but if you don’t have that kind of time I think that going through it once and then just going over your wrongs is enough!

FIRST AID/FIRST AID EXPRESS:

This book is the bible of medical school and each time I read it I find new words I haven’t seen before. Its well organized, has all the important information regarding each disease, and most questions you will ever do can be answered by looking at a page in First Aid. With that being said, don’t use this book to learn- that’s not what its meant for. Use it to review and reference. I used the Anki “brosenecephalon” deck online to turn it into a more active learning experience and quiz myself on first aid bits of information. Know this book as well as you can and it will be to your advantage on test day. I also annotated my book with UWORLD info and put little tabs for each chapter so that I could reference chapters more quickly. I went through the book chronologically and used it as my guide for organizing my studying. I went through the organ system chapters in order of when we covered it in our medical school (heme-lymph, cardio, pulm, renal, GI, endo, repro, neuro, MSK, psych, stats/EBM. I went through the book a second time through during dedicated (2 weeks) and looked through it a third time the week leading up to my exam for 3 passes in total. When I went through it my first time it was too difficult to just read casually because of how dense it was so I used First Aid EXPRESS videos and I really enjoyed having someone talk through the book with me.

PATHOMA: 

Dr. Sattar is an absolute legend and he explains the pathophysiological origins of disease really clearly. I highly recommend going through Pathoma at least once during your STEP studying and periodically reference it as you study. I HIGHLY recommend reviewing chapters 1 & 2 of Pathoma leading up to your STEP exam as it has so many high yield principles in regards to basic immunology and pathology that STEP 1 writers love to ask about. High Yield 😉

SKETCHY MEDICAL:

SO, SO GOOD! For all my visual learners out there, this is a must-use resource for studying. It can be a huge time commitment, especially for pharm, but you really reference this often  even when you go into the wards. I used sketchy micro and pharm and I really enjoyed it as it helped me have a little visual in mind when it came to answering questions AND its super memorable and even fun. I used an ANKI sketchy deck to quiz myself and the two days leading up to my exam I looked at the pictures one last time to have the images fresh in my mind. Don’t forget to look through the Micro chapter of First Aid as it has some stuff in there that isn’t covered in Sketchy.

3. Complete all the NBME exams and do the practice test at the test center

These are the closest thing to the real exam as they are old questions released by the NBME and they get you into the comfort of taking 40-50 question blocks. I took roughly one test a week and it moved up to two a week leading up to the exam. There are 6 NBME  exams (13, 15, 16, 17, 18, and 19) and there is a shorter test that you can take at the testing center that I highly recommend. If you’re like me and have test anxiety, this is extremely helpful for giving you a trial run of what STEP 1 feels like. You practice signing in, fingerprinting, seeing the test center, looking at the monitor interface, and being comfortable. Treat it like STEP 1 and simulate the conditions as much as you can because it will make your real STEP 1 test day feel way less scary.

4. Break up your days and change up your locations

Studying for STEP can be exhausting and being in the same place all day can make you go crazy. I was in this small cubicle that I transformed into my own study space (see instragram post for visual) and I loved it. I had a yoga mat, diffuser, laptop stand, white board, and I turned it into my own little space. Even with that, I still needed to move around occasionally and find different places in the library and other buildings on campus to study just to give myself a change of scenery.

 

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5. Integrate some group studying and integrated review into your studying:

Nothing is more memorable than discussing concepts in a small group setting. A classmate and I had very similar schedules so he and I reviewed concepts together in the evenings, which was nice for two reasons. 1. It broke up the days and made them feel less exhausting/dreary and 2. every student picks up on different things and it forced me to think about concepts I didn’t remember well and teach a fellow student some of the things I learned and reinforce my learning. Win-win! Especially near the end of STEP studying I spent a lot of time integrating topics and thinking multi system because in reality, STEP 1 isn’t going to just test you on an isolated organ system so it works to your benefit to think broad. I would think about cancer and where it can affect people very broadly, I drew out diabetes pathways and meds, drew out all the types of cells that have action potentials and how they worked/looked, drew out immunodeficiencies, etc. It ended up being very helpful and I highly recommend incorporating some integrated review in your weekly studies.

6. Don’t allow this test have emotional control over you!!

This one is the hardest to tell people because we all struggle with it while we’re studying and you just have to honestly experience it for yourself. I remember how daunting this exam felt and I added all this emotional weight to the exam, which can sometimes be really distracting. While STEP 1 is very important, you have to remind yourself that everything will be okay after STEP and that your score doesn’t define you as an applicant- just like the MCAT didn’t. If you’re considering a competitive specialty (Derm, ENT, Plastics, Ortho) then a higher STEP 1 score is more important but its not the end-all be-all thing in an application. Give this exam your best effort and push yourself to learn as much as you can but don’t let this exam being over be the key to your happiness. You will just find something else to stress out about right after STEP 1 is over. Schedule some yoga or do some morning gratitude whenever you’re feeling down or stressed and it can really help!

7. Quality hours > quantity of hours

This is a very important one to think about as you plan your schedule. Some people need to do 14 hour days in order to feel prepared and confident for exam day but this doesn’t work for everyone. Some people thrive more on putting in 6-8 good strong, quality hours so figure out for yourself what works best for you. Don’t think that the number of questions you do in UWorld or the number of resources you burn through will equate to the score you will get.  Go through them and learn- don’t just rush through resources and questions just to say you finished them. Put in good, quality, focused hours when you are studying and keep the distractions to a minimum. Just something to consider as you prepare your schedule!

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8. Most importantly- don’t forget to take care of yourself!!!

Even with STEP studying being a difficult time, I always made sure to take care of my body and my health, not just for the sake of my happiness but also to ensure I was mentally rested to maximize my study days. 14 hour study days suck so giving myself an hour or so to go to the gym in the middle helped give me a break in my schedule and allowed me to feel like I was doing something good for myself. I slept 7 hours a night, ate clean throughout my studying, and made sure to have plenty of snacks to give me a little glucose when my brain was fried. Also its totally up to you but whether you want to schedule in your breaks (which I did and recommend) or just have them when you or your body feels like it needs/deserves one- allow yourself to rest and relax once a week for a day or so. For me, I would take an NBME and grade it on fridays and give myself the rest of the evening to enjoy a cheat meal and relax at home with my friends. Sunday night I would come home a little early and meal prep + do laundry and that worked well for me. Hitting the reset button is very important when you’re feeling burned out and its amazing what one night of relaxation and rest can do for your energy and mood!

If you have any questions, please email us at gainsanatomy1@gmail.com. Please comment below and share with friend who are studying for STEP 1 as this may be helpful to them!

 

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