For Med Students preparing to take the USMLE Step 1

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STUDY PACK
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table of contents
Introduction....................................................................................…….. 3

USMLE Roadmap................................................……............................. 4

Sample Study Schedule...................................................................... 5-6

5-Step Study Process.............................................................................. 7

4-steps to Approaching Question Stems........................................... 8

How to use Practice Tests...................................................................... 9

Common Questions......................................................................... 10-11

Sample Test Day Equation Sheet....................................................... 12

Other Resources for Step 1................................................................. 13

Full Pages from MedSchoolBro Guides...................................... 14-23

Link to our Discord & Weekly Webinars........................................... 24

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You’ve made a
great decision!

Congratulations on taking the next step in

your journey to being a physician!

This guide goes over the USMLE Step 1

and shows you my favorite test-taking
strategies, study schedules, other helpful
resources, and even has full pages from
my complete guides! I have complied all
my top tips that helped me pass the
USMLE with ease :)

Happy studying, and as always... study

smarter, not harder!
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sample study log
Here is a sample study schedule that you can use for a Step 1 and 2
dedicated period! Having a study schedule and study tracker will be
crucial in keeping you organized during your review time. Notice in
the beginning half of your study period, we recommend having a
rotating schedule of content review with consistent questions.
Towards the second half, we recommend you transition to focusing
more on NBME Question materials as these tend to be the most
predictive. Everyone will have a different study timeline and
approach, so be sure to watch our webinar that reviews how to and
what you should consider in creating your own individualized study
schedule.

While the study schedule will keep track of the content and questions
you are reviewing daily, the study tracker will keep track of your
practice test scores and weaknesses. For each practice test you take,
make sure to record the date, individual section scores, and most
importantly notes about how the test felt in terms of question type,
timing, or anything else about the test experience you may have
been uncomfortable with. This will allow you to notice trends over
time. For your weaknesses, make sure to keep track of what content
you consistently miss questions of or don’t understand fully. This list
will help you tremendously when you’re towards the end of your
study period and need a list of topics that you should brush up on.
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step 1 study schedule

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Content Content
Content Content Content Content Review – Review –
Review – Review – Review – Review – Med School Med School
Diagnostic
Week One Pathoma, Pathoma,U Pathoma,U Pathoma,U Bro Cardio Bro Cardio
Test
UWorld 2-3 World 2-3 World 2-3 World 2-3 Guide; Guide;
Blocks Blocks Blocks Blocks UWorld 2-3 UWorld 2-3
Blocks Blocks

Content Content
Content Content
Review – Review –
Review – Review – Content
Med School Med School Review
Med School Med School Review – NBME
Bro Bro Practice
Week Two Bro GI Bro GI First Aid; Practice
Neurology Neurology Test; Half
Guide; Guide; UWorld 2-3 Test
Guide; Guide; Day Off!
UWorld 2-3 UWorld 2-3 Blocks
UWorld 2-3 UWorld 2-3
Blocks Blocks
Blocks Blocks

Content Content Content Content Content

Review
Review – Review – Review – Review – Review – NBME
Practice
Week Three First Aid; Sketchy; First Aid; First Aid; First Aid; Practice
Test; Half
UWorld 2-3 UWorld 2-3 UWorld 2-3 UWorld 2-3 UWorld 2-3 Test
Day Off!
Blocks Blocks Blocks Blocks Blocks

Review NBME Free Review High Review High

NBME
Practice 120 & Yield Yield Relax &
Week Four Practice Test Day!
Test; Half Review Content/We Content/We Celebrate
Test
Day Off! Weaknesses aknesses aknesses
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5-step study process

Click or scan to watch my 5-step video

Priming
The first step, priming, involves exposing yourself to new content, terms, and concepts. This step
helps build neural pathways and connections in your brain to facilitate better retention and
consolidation of information. By immersing yourself in various resources like videos, podcasts, and
notes, you prepare your mind to absorb and understand the material.

Absorb
In the second step, your focus is on understanding the concepts rather than mindlessly copying notes
or reiterating information. Whether through lectures or online curricula, you aim to comprehend the
content and avoid wasting time on passive learning. This step involves actively engaging with the
material to establish a strong knowledge base.

Active Learning
Similar to the point above, did the vignette specifically mention the patient’s age, sex, ethnicity,
location, occupation, past medial history, family history, medications, vital signs, etc.? All of these
pieces of info are included to help you lead you to the diagnosis in question. For instance, if the stem
explicitly states a 35-year-old African American woman with concurrent diabetes… who has a malar
rash. Well, 4 key pieces of info: middle age, female, African American & concurrent autoimmune
disease all point towards SLE.

Revise
In this step, you revise the material by summarizing key points, using mnemonics, and creating
diagrams. It is the first time you actively write and engage with the content to reinforce your
weaknesses. This step aims to consolidate your understanding and solidify the information in your
memory, making it easier to recall later.

Active recall
The final step, active recall, focuses on long-term retention. By incorporating tools like Anki or
flashcards into your study process, you repeatedly review and recall the information over time. This
step ensures that the learned material remains accessible and ready to be retrieved even after several
months, ultimately enhancing your exam performance.
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4-steps to APPROACHING QUESTION stems

Click or scan to watch my 4-step video

Read the last line first

This sets up the question and what you need to look for. Is it a simple first order question (i.e. what is the most likely
diagnosis)? A second order question takes it a step further (i.e. what is the 1st line medication used for this patient?) The
test maker expects you to pick up on the diagnosis using the vignette. Finally, you may get some third order questions (i.e.
what is a side effect of the medication that is most likely used in this patient?). The test maker expects you to know the
diagnosis, first line medication & common side effect of this medication.
You should also read the last line first because you’ll always get some questions where the last line is all you need to answer
the question (i.e. what is the mechanism of action of X drug), which saves you LOTS of time.

Pertinent Positives & Pertinent Negatives

Pay close attention to these details. If the question specifically states that the patient is febrile & high CRP, then they may be
telling you this to think of an infective/inflammatory process. The opposite is true with pertinent negatives. If the stem
mentions the patient has no fever or neck stiffness, then they DON’T want you thinking about meningitis. Pertinent
positives & negatives are key pieces of the stem that help guide you to the test makers thought process.

Pay attention to the details

Similar to the point above, did the vignette specifically mention the patient’s age, sex, ethnicity, location, occupation, past
medial history, family history, medications, vital signs, etc.? All of these pieces of info are included to help you lead you to
the diagnosis in question. For instance, if the stem explicitly states a 35-year-old African American woman with concurrent
diabetes… who has a malar rash. Well, 4 key pieces of info: middle age, female, African American & concurrent
autoimmune disease all point towards SLE.

Picking the correct answer choice

After you finish the above steps, try to have a guess in your head about what the patient might have BEFORE looking at the
answer choices. Often seeing the answer choices can confuse or mislead you to one answer over another. Now there are a
few strategies:

A) If you’re confident with your understanding of the stem & what the question is asking, go ahead and mark down the
answer you believe is correct. Be sure to refer to your pertinent positives/negatives & details in the stem to confirm this.
You can also go through the other answer choices and strikethrough each as you build evidence that they are not the
correct answer choices.

B) If you’re NOT confident in one answer choice off the bat, start by striking out the answer choices one at a time. There is
a good chance you can strike out 2-3 based on the pertinent positive/negatives & details check we mentioned above. If you
get it down to 2 and you’re really struggling, typically go with your gut (aka trust your prep). If you have the time, you can
also tally up the evidence in the question stem that supports each answer choice and pick the answer with more tallies.

C) If you have 0 idea what’s going on and you’ve read the question to yourself 3 times now, guess & move on. If it sounds
wonky its probably one of the experimental questions the USMLE includes.
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how to use practice tests

Which should I use?
UWSA = 4 blocks or 40 questions over 4 hours
NBMEs =4 blocks of 50 question blocks over 5 hours
Free 120s with explanations

How many should I take?

Studies have shown that you should take 6-9 practice tests
Early on in your study period take an NBME as a diagnostic to measure where you
are at so you can tailor your study plan accordingly
As you get closer to test date, ramp up your full length practice tests to at least 1
per week so that you build up stamina and have a good performance indication as
to whether or not you are ready

How should I review each test?

Divide your mistakes into Content Mistakes & Test-Taking mistakes, here’s an
example:

CBSSA Form 27 Correct 144/200

Projected: 99% of passing if you take Step 1 in a week

Content Mistakes
Retention (forgot a fact or details related to question)
Application (didn’t understand topic enough to apply to question stem)
Gap in knowledge (never seen topic/detail before)
Test Taking Mistakes
Missing key information/details from vignette
Knew info but misinterpreted question
Incorrect diagnosis
Didn’t choose answer with mot evidence
Guessed or switched answer

By structuring each review like this, you can analyze where most of your mistakes are
coming from a focus on that area
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Common questions
There are so many resources - what do I actually need?
Must: UWorld Step 1 Q-Bank, UWSA, NBME forms, Pathoma Chaps 1-3
UWorld: try to get through the full step 1 bank – I would recommend doing timed
sessions of 40 questions to imitate test day conditions.
NBME forms: take one early as a diagnostic, then start to ramp them up to 1
form/week as you get close to test day
UWSA: I did these towards the end (final 2 weeks) to get a gauge of where I was
it/my readiness to sit Step 1
Pathoma chaps 1-3 are exceedingly HY, tons of questions from my step 1 came
right from there!
Preference: Content review (MedSchoolBro guides, FA, AnKing, etc).
How you choose to do your content review/active recall is up to you/what
resources best stick with you!
AnKing is a great deck (but I must admit there are tons of cards with details you
really don’t need to focus on for step 1)
My rapid review guide series are an essential summary of all high yield topics on
step 1 which also come with a custom anki deck – highly recommend in the later
stages of your prep!

How do I know I’m prepared enough to pass Step 1?

Passing Step 1 is incredibly important for matching into a residency program. It is
imperative that you are as prepared as possible walking into the test to give
yourself the best chance of passing. That being said, the best metric to understand
your preparedness is your NBME scores as well as your Free120 results. The NBME
examinations for Step 1 give you an expected percent chance of passing the exam
within a week in each score report. There is no clear threshold for which you know
you are prepared enough, but we recommend having at least 2 consecutive
practice tests with a >95% chance of passing.
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Common questions
My scores aren’t improving, what can I do?
First of all, breathe. This is an extremely common scenario for most test takers.
The first step in improving is reviewing your practice exams and UWorld blocks
in detail to figure out why you are getting answers wrong. Is it a knowledge gap
in content, are you running out of time or rushing, or is it that you are getting a
lot of concepts you are weaker on? Either way, continue completing practice
tests and question banks throughout your study period, even if you are not
seeing progression in your scores. By completing more question sets, you are
building your knowledge base to improve on test day. Be sure to reach out to
your mentors in the MedSchoolBro Discord community for further assistance.

How to prepare in my final week?

1. Do one more pass of Pathoma chaps 1-3 (exceedingly High Yield)

2. Free 120's. In my opinion, the Free 120’s were the closest representation of
the difficulty/style of question I saw on test day… for that reason I left them to
the end to use as a diagnostic before test day!
Free 120 Questions here + Free 120 Answers here
OLD Free 120 as of writing this + OLD Free 120 explanations

3. Factoid content review… this is mainly pure memorization. Sometimes you

just need to get a bunch of information into your short term memory
Equation sheet & biostats review here
Psych definitions & DSM5 stuff
MSK/derm (i.e. dermatomes/myotomes)
Pharm (HY MOAs, AEs, etc)
Receptor signalling
Gram + & gram – micro flowchart
4. High yield images docs here
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sample test day equation sheet

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Other Great resources for step 1

AAMC Materials: It is incredibly high yield to take practice tests throughout your
dedicated study period. Along the way, you will find the official NBME exams by
the AAMC as a core resource to see your progression as you build your
knowledge base. Don’t be discouraged by low scores in the beginning of your
dedicated block, as you should improve along the way. As of January 2024, there
are 7 available NBME Step 1 practice tests. Be sure to also complete the NBME
Free120, a free 120 question examination most comparable to your real test, as
the last practice test in your preparation.

UWorld Step 1: This is an excellent bank of test questions that is a staple for all
medical students taking on Step 1. Each section bank of questions is incredibly
high yield for Step 1 and the question explanations really elevate this platform as
a key resource.

First Aid: This is the holy grail of reference materials for Step 1. First Aid covers
almost every topic that you will come across on the test, but it can be
overwhelming. Try not to get too bogged down by the text and memorize every
single line. Instead, utilize the book as a reference material to cover topics you
are less familiar with.

Pathoma: The first three chapters of this book are incredibly high yield for the
Step 1 examination. These short chapters come up repeatedly on the practice
materials, and anecdotally some of us had concepts from these chapters appear
on the real examination.

Sketchy: Both Sketchy Micro as well as Pharmacology are great reference

materials to understand the content portion of the Step 1 exam. These cartoons
truly stick with you as you are tackling the test and are incredibly high yield
material for any study plan.
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