USMLE Step 1 Support Session

August 31, 2017

Updated Practice and Informational Materials
for the Step 1 Examination Available
Announcement posted to USMLE website February 21, 2017

Updated practice and informational materials for the Step 1

examination have been posted to the USMLE website.
Examinees planning to take a Step 1 examination should read the
following materials and practice with the updated sample items:

Tutorial and Practice Test Items for Multiple-Choice Question

USMLE Step 1 Sample Items Booklet (PDF)
USMLE Step 1 Content Description and General Information Booklet
(PDF)

View this announcement on the USMLE website. Please share this

information with students, faculty and appropriate staff at your school.
Test Accommodations
Test accommodations include but are not limited to the
following:
 Assistance with keyboard tasks
 Audio rendition
 Extended testing time
 Additional break time
 Enlarged text and graphics
 Permission for assistive devices
Detailed information about test accommodations while taking a USMLE examination is available at the USMLE website.
Self-Assessment Services
 The NBME provides a variety of web-based self-
assessments to US and international medical
students and graduates through the NBME Self-
Assessment Services interactive site.
 Comprehensive self-assessments allow you to
evaluate your readiness to take USMLE® Step 1,
Step 2 Clinical Knowledge (CK) and Step 3.

Target your studies using diagnostic feedback

highlighting areas of strength and weakness.

Use your self-assessment score to estimate your

approximate score on the USMLE score scale.
The average Step 1 scores for the last
several years:
Year HMS National

2012 239 227

2013 239 228

2014 243 229

2015 243 229

2016 243 229

(This is interim data thru September 2016.)

Faculty subject reviews from 2015

 Biochemistry Review USMLE Step1 with

Randy King 2/19/15
 NBME Step 1 Neurology Review with Dr.
Chang 2/26/15
 NBME Step 1 Microbiology Review with Dr.
McAdam 3/2/15
 Immunology Review USMLE Step1 with Andy
Lichtman 2/17/15
General Study Tips
 Make a schedule and try to stick to it.
 Try not to schedule any big events during your study time.
 Take frequent breaks
 Be sure to exercise
 While studying, getting a good night¹s sleep is important to feeling refreshed and
ready to study

The Week Before

 Focus on the Qbank

 Try to wake up around the time you would on test day, to prevent feeling drowsy
during the test.
 Take a trip to the center to see how long it takes you to get there.
 The day before do things that are relaxing Š watch a movie, go shopping, go for a
run, etc.
 Try not to take any sleeping pills as this might affect you the next morning.
 Have your meals and snacks planned out.
 The day of the exam- breath, relax, think about a nice breakfast and then a healthy
lunch. Know you are well prepared.
STUDENT PANELISTS
Panel Support from Afar

 Aditya Ashok  Severine Cao

 Enrico Ferro  Sean Fletcher

 Gillian Horwitz  Diego Lopez

 Tracy Makuvire  Christine Santiago

 Eugene Vaios  Laurie Schleimer

 Winona Wu

 Travis Ian Zack

Enrico Ferro
Step 1 Study Resources:
 Uworld Qbank
 Picmonic
 First Aid for Step 1
 Pathoma (with videos)\
 Three full-length practice NBME’s
 Kaplan videos specifically for biochemistry, embryology, some pharmacology topics (like the
mechanism of different anesthetics or anti epileptics etc.) and some anatomy (like the
lumbar/brachial plexus).
 Selected textbooks from pre-clinical years (reviewed as needed for selected topics, however
this may not be as useful if you did not already use and become familiar with these
books during pre clinical years):
*** Lippincott Illustrated Reviews – Pharmacology
*** Clinical Microbiology Made Ridiculously Simple
 Blumenfeld’s Neuroanatomy Through Clinical Cases
 Licthman’s Basic Immunology
 Schwartzstein’s_Respiratory Physiology
 Lilly’s Pathophysiology of Heart Disease
Enrico Ferro
Study Schedule
I took the total number of questions on Uworld (2000
+ questions) and divided it by the number of study
days, making sure to leave at least 1 week aside to
review all the flagged Uworld questions, and 2-3
additional days to take the full length practice tests
as described above.

Next, I divided the questions by topic (i.e. psychiatry,

surgery, peds etc) and worked through one topic at a
time. Every time I encountered a question dealing
with a topic I did not feel comfortable with, I reviewed
it thoroughly using all the resources listed above.

For step 1 only, I read through First Aid and Pathoma

(with videos) before starting a given block on Uworld.
Enrico Ferro
Overall Study Tips:

 Identify as few study resources as possible, and try to go through them multiple times.
 If possible, prioritize resources that you have already used during pre-clinical years or
during the PCE.
 Avoid skimming just once through a vast amount of resources, or relying heavily on
brand-new resources that you have not used before.
 Organize the test blocks on Uworld by specific topics (i.e. all biochem questions
together forstep 1, all surgery questions together for step 2 etc), do not create mixed
tests (i.e. mix ofsurgery and neurology) to “simulate the actual test”.
 The NBME practice exams are the best way to simulate the actual test.
 The advantage of doing Uworld tests by specific topic is that you will be able to identify
recurrent themes and patterns within a given topic, which will guide your studying
andreview process:
 As you do your first pass through Uworld, flag questions that you got wrong, but also
questions that you got right only because you became “habituated” to a topic point
above): you want to review these very common topics as the test approaches, because
they are most likely to show up on test day!
 Make a short document of random factoids that you have trouble remembering
 Use mnemonics/picmonics, especially for topics where you feel the weakest:
 Especially for step 1, find a way to review and retain information as the weeks/months
progress. Some people use Anki, others Firecrakers etc. For example, I made a list of
biochem, microbio, pharmacology Uworld questions that I found particularly
challenging or important,and every day I would set aside 10-15 minutes to do 5-10 of
those questions.
Aditya Ashok
 Firecracker
 Anki study decks
 First Aid
 Practice tests.
 Eugene Vaios STUDY SCHEDULE
Weeks 1-6 Week 7
Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8AM 8AM
9AM 9AM
10AM 10AM
11AM 11AM
12PM Break Break Break Break Break Break Break 12PM Break Break Break Break Break Break Break
1PM- 1PM-
6PM 6PM

Week 8 Week 9
Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8AM 8AM
9AM 9AM
10AM 10AM
11AM 11AM
12PM Break Break Break Break Break Break Break 12PM Break Break Break Break Break Break Break
1PM- 1PM-
6PM 6PM

Legend:

Pathoma
Sketchy Micro
Sketchy Pharm
First Aid
UWorld Questions&Review
NBME Exams&Review
General Review of Study Notes
 Gillian Horwitz

Wednesday 3/29 Thursday 3/30 Friday 3/31 Saturday 4/1 Sunday 4/2

8 - 11 AM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block OFF

11 AM - 1:30 PM Pharamcology Immunology Biochemistry Biochemistry

1:30 - 2:30 PM Pharmacology Flashcards Pharmacology Flashcards Biochemistry Flashcards Biochemistry Flashcards

2:30 - 5:30 PM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block

8 - 9:30 PM Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize

Inflammation, Inflammatory Disorders, and Healing 131 min

Monday 4/3 - CL Tuesday 4/4 - CL Wednesday 4/5 - HS Thursday 4/6 Friday 4/7 Saturday 4/8 - HS Sunday 4/9

8 - 11 AM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld Self-Assessment 1 Uworld 40Q Block Uworld 40Q Block OFF - WORK ON PAPER

11 AM - 1:30 PM Pathology Microbiology Microbiology Microbiology Cardiovascular

1:30 - 2:30 PM Pharmacology Flashcards Pharmacology Flashcards Microbiology Flashcards Microbiology Flashcards Microbiology Flashcards Microbiology Flashcards

2:30 - 5:30 PM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block

YOGA

8 - 9:30 PM Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize

Growth Adaptations, Cellular Injury, Cell Death 91 min

Monday 4/10 Tuesday 4/11 Wednesday 4/12 Thursday 4/13 Friday 4/14 Saturday 4/15 Sunday 4/16

8 - 11 AM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block NBME Exam 1 (Form 13) Uworld 40Q Block Uworld 40Q Block OFF - WORK ON PAPER

11 AM - 1:30 PM Cardiovascular Respiratory Respiratory Neurology Neurology

1:30 - 2:30 PM Pharmacology Flashcards Microbiology Flashcards Biochemistry Flashcards Pharmacology Flashcards Microbiology Flashcards Pharmacology Flashcards

2:30 - 5:30 PM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block
 Gillian Horwitz
8 - 9:30 PM Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize
Cardiac 55 min Vascular 41 min Respiratory 80 min CNS 56 min
Monday 4/17 Tuesday 4/18 Wednesday 4/19 Thursday 4/20 Friday 4/21 Saturday 4/22 Sunday 4/23
8 - 11 AM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block NBME Exam 2 (Form 15) Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block
11 AM - 1:30 PM Heme/Onc Heme/Onc Endocrine MSK/Skin/CT MSK/Skin/CT Biochemistry Flashcards
1:30 - 2:30 PM Pharmacology Flashcards Microbiology Flashcards Biochemistry Flashcards Pharmacology Flashcards Biochemistry Flashcards Pharmacology Flashcards
2:30 - 5:30 PM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block

Uworld 20Q Block Uworld 20Q Block

8 - 9:30 PM Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize
Neoplasia 81 min Hemostasis 65 min WBC 69 min RBC 96 min Endo 54 min MSK 45 min
Monday 4/24 Tuesday 4/25 Wednesday 4/26 Thursday 4/27 Friday 4/28 Saturday 4/29 Sunday 4/30
8 - 11 AM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block NBME Exam 3 (Form 16) Uworld 40Q Block Uworld 40Q Block
11 AM - 1:30 PM Renal Renal Reproductive Reproductive Gastrointestinal
1:30 - 2:30 PM Pharmacology Flashcards Microbiology Flashcards Biochemistry Flashcards Pharmacology Flashcards Pharmacology Flashcards Biochemistry Flashcards
2:30 - 5:30 PM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block

Uworld 20Q Block Uworld 20Q Block Uworld 20Q Block Uworld 20Q Block
8 - 9:30 PM Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize Pathoma/Memorize
Skin 28 min Kidney/GU 56 min Female repro 96 min Male repro 24 mi, Breast 35 min
Monday 5/1 Tuesday 5/2 Wednesday 5/3 Thursday 5/4 Friday 5/5 Saturday 5/6 Sunday 5/7
8 - 11 AM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Review Wrong Uworld Review Wrong Uworld Review Wrong Uworld Review High Yield Topics
11 AM - 1:30 PM Gastrointestinal Behavioral Science/Psychiatry Review High Yield Topics Review Wrong Uworld Review Wrong Uworld Review Wrong Uworld
1:30 - 2:30 PM Flashcards Flashcards Flashcards Flashcards Flashcards Flashcards
2:30 - 5:30 PM Uworld 40Q Block Uworld 40Q Block Uworld 40Q Block Review Wrong Uworld Review Wrong Uworld Review Wrong Uworld
Review Wrong Uworld Review Wrong Uworld Review Wrong Uworld

Uworld 22Q Block

Pathoma/Memorize Pathoma/Memorize
GI 92 min Panc/Liver/GB 38 min
Monday 5/8
TEST
DAY
!!!!
Tracy Makuvire

USMLE Practice Exams

Tracy Makuvire

USMLE Practice Exams

 2 UWORLD USMLE Tests – included with UWORLD 8
week subscription
 6 available NBME Practice Exams - $60 per exam
 How did I use practice exams?
 Week 1: Baseline exam – 1 NBME exam, 200 Qs, 4 hours,
timed
 Week 3: 2nd NBME, 200 Qs , 4 hours, timed
 Week 5: USMLE World Practice Test, 200 Qs, 4 hours, timed
 Week 6: 3rd NBME + UWorld Q’s, 280Qs, timed
Tracy Makuvire

 ** 5 days before exam– 2nd USMLE Exam, 200 Qs, 4 hours

timed – Skipped this exam

 Reflections:
 ALWAYS review practice questions, correct + incorrect
 Would skip week 3 NBME exam, post-pone to week 4 after I had
finished study material
 Use both USMLE exams, included with subscription, answers
provided
 NBME exams best predictors of score. Use the most recent
form right before exam
 Give your brain some rest before actual exam. Would not do a
full practice exam within 5 days of test.
Winona Wu

 MAINTAINING ACCOUNTABILITY TO
YOURSELF!
Eugene Vaios
General Advice
 It’s only a test – what matters is who YOU are as a person, not an exam score.
 Don’t study for the score. Study for your patients and to master the material so you
can be a great physician. Understanding the greater purpose behind your test prep
will sustain you through your studies.
 Try doing an NBME on the first day of your studies as a diagnostic – it will help you
appreciate how much you’ve learned by the end of the study process!
 Be flexible with your study program – take plenty of breaks when you need them.
 Stamina is a major part of the exam. Use the UWorld and NBME exams as a tool to
simulate the test taking speed and the length of the real exam.
 Approach the question bank and practice exams as a study tool, not as an
evaluation of how you will perform on the actual exam.
 If possible, do the UWorld question bank 2x. Go through your 1st pass untimed and
read all question answer keys as you go along (correct and incorrect questions).
Your 2nd pass, try to do timed 40-question blocks. If possible, try to simulate a test
day (ie. 7 blocks). Read the answer keys of only the questions you got incorrect or
were unsure on.
 *UWorld will reset your account if you previously purchased, but did not reset,
your Step2 Qbank during PCE.
 During your 1st pass in the question bank, focus the questions on content areas (ie.
Nervous system). Your morning “didactic prep” should mirror the question bank
subject (ie. Cover the nervous system lectures in pathoma and first aid, and review
the drugs related to the nervous system on sketchy pharm).
 Sketchy pharm is not as easy to learn as Sketchy micro. However, once you learn the
images, the return on your investment is enormous.
 Pick your study resources and stick to them. There are many tools for Step 1 prep,
but it is better to select a small number and master them in depth. Do not lose faith
in your study program, even if other classmates are using different resources.
Travis Ian Zack

 MANAGING DOUBTS AND WORRIES!

Travis Ian Zack
Congratulations!

Most of the hard work is already behind you

• The vast majority of things you need to know for

Step 1, you have already learned, before you have
even started your dedicated time

• You have already had multiple simulated practice

tests that are much harder and more detailed than
Step 1 will be (your shelfs)

• You are already starting at such a great advantage

Support from afar
Diego Lopez
Information on the Boards & Beyond resource!
 They are extremely well-made high-yield lectures
about almost every topic covered in Step 1.
 Given that I was 1+ years away from preclinical
courses, these lectures were extremely helpful in
reviewing/re-learning a lot of foundational topics (it
saved my life with Biochem!).
 Relatively cheap compared to other resources.
Christine Santiago
STEP SCHEDULE (56 days)
mix every 3rd day and more as go along after first few weeks
3/30- 4/2

0 Prior Thursday Friday (start studying) Saturday Sunday

NMBE Practice Test 13- 159 Get ready/ prep schedule Micro Micro Micro

4/3- 4/9
Start mix every 3rd day and Pharm daily
1 Monday Tuesday * mix Wednesday Thursday Friday Saturday (1/2 day) *mix Sunday
Biochem (Metabolism)- brute
Immunology (First aid + Pathoma Pathology (Pathoma + Biochem (Molecular/ Cellular/ Biochem (Genetics, Nutrition) - Behavioral Science/ review Pharmacology + flashcards/
force memorization, flashcards
+ UWORLD) UWORLD) Lab)- flashcards + first aid flashcards + first aid metabolism/ consolidate Broencep
+ first aid

4/10- 4/16
Start mix every 3rd day and Pharm daily, start timed 20 q set
2 Monday Tuesday *mix Wednesday Thursday * mix Friday Saturday (1/2 day) Sunday *mix
Endo Endo/ pharm Heme/Onc Heme/Onc/pharm Repro/ consolidate/ pharm/
Repro MSK/Derm/CTD
UW: 60-80 UW: 60-80 UW: 40 UW: 80 weaknesses chart
UW: 60-80 UW: 55
Flex Flex UW: 44

4/17- 4/23
Start mix every 3rd day and Pharm daily, all q banks timed- get to 40q set
3 Monday pharm +
MSK/Derm/CTD/ Tuesday Wednesday *mix Thursday Friday Saturday (1/2 day) *mix Sunday
Neuro Neuro/ pharm
antibiotics GI GI /pharm Resp/ consolidate/ biochem Resp/pharm
UW: 60-80 UW: 60-80
UW: 60-80 UW: 60-80 UW: 60-80 UW: 40 UW: 60-80 *CNS drugs
*CNS/ ANC drugs

4/24- 4/30
Start mix every 3rd day and Pharm daily, 40 q sets times multiple
4 Monday Tuesday *mix Wednesday Thursday Friday Saturday (1/2 day) Sunday
Renal Renal/ pharm Cardio Cards/pharm Psych/ Pharm
weaknesses/ consolidate (review
UW: 60-80 UW: 60-80 UW: 60-80 UW: 60-80 NBME 16- 219 UW: 60-80
exam)

5/1- 5/7
5
Monday Tuesday Wednesday (morning q bank) Thursday (morning q bank) Friday (1/2 day) Saturday Sunday (morning q bank)
Micro (afternoon videos of Biochem (FA)/ weaknesses/ weaknesses/ consolidate
Behavioral Science GI Heme-Onc (1) (40Q) Neuro 80Q
incorrect)- AM antibiotics and flashcards memorize (microbiology)/ flashcards

5/8- 5/14

6 Monday (morning q bank) Tuesday (morning q bank) Wednesday (morning q bank) Thursday (morning q bank) (1/2 day) Friday Saturday Sunday (morning q bank)
weaknesses/ consolidate (immuno
MSK/Derm/CT NMBE Practice Exam (17)-
Endocrine Genetics (Biochem) Repro (embryo) diseases)- check weakness sheet Renal/ Respiratory
80Q 228
(pharmacology FA/ fatty acid

5/15- 5/21

7 Monday (mixed sets) Tuesday (mixed sets) Wednesday* last 10 day schedule Thursday (Mixed sets) Friday
Neuro (anatomy)- make specific Behavioral (redo questions 2 sets of 40(Mixed sets) am,
questions Saturday Sunday (Mixed sets)
3 sets of 40 Q, Afternoon Afternoon review/ error Read First Aid / Rapid review/ 3 sets of 40 Q, Afternoon
no rewatching pathoma/ General from video)/ Micro (plus NBME (18)- 219
review/ error analysis analysis + rapid review qbank, afternoon one set of 40Q review/ error analysis
principles drugs (Pharm section)/ drugs)/ Drugs (antiarrythmics/
5/22- 5/26
8
Monday (Mixed sets) Tuesday (Mixed sets) Wednesday (Mixed sets) Thursday (1/2 day) Friday
2 sets of 40 questions am, Read First Aid / Rapid review/ 2 sets of 40 questions am, Optional final review, Exam Day!!!

"There are three elements to success: hard work, natural talent, and luck. Unfortunately, we can only improve the first."

Friday 5/26 = Step 1 Goal 240: Actual 235

 Q banks
1) Take them timed
2) Quick run through categorizing type of errors

Christine 3) Which concepts need to review for most questions

4) Review those concepts

Santiago

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Work in sets of 2 hrs
then 10 minute break
8am-12:00pm Pathoma or First aid

Lunch Lunch Lunch Lunch Lunch Lunch Lunch

End at 3pm
1:30-5:30pm 60Q timed / review
Off

Dinner/ workout Dinner Dinner Dinner Dinner Dinner Dinner

Off

8- 9 hr study per day

DAILY

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

6:00 AM Run Workout Run Open Workout Run OFF
7:00 AM Breakfast
8:00 AM Consolidation Consolidation
9:00 AM First Aid
10:00 AM
11:00 AM
12:00 PM Lunch
1:00 PM Pathoma BREAK
2:00 PM Subject Mixed Mixed
3:00 PM 40 Q’s Subject Subject Mixed Subject Subject Mixed Mixed Mixed Mixed
4:00 PM Error Analysis
5:00 PM Consolidate
6:00 PM Break
7:00 PM
8:00 PM Cards

LAST 10 Days
Sun. 10 Mon. 9 Tues. 8 Wed. 7 Thurs. 6 Fri. 5 Sat.4 Sun. 3 Mon. 2
8:00 AM NBME Block 44 Q’s
44 Q’s
44 Q’s 44 Q’s
44 Q’s 44 Q’s
44 Q’s 44 Q’s
44 Q’s
44 Q’s 44 Q’s
44 Q’s Rapid Review 44 Q’s
44 Q’s Optional Final Review
9:00 AM
10:00 AM
11:00 AM
12:00 PM OFF and REST J
1:00 PM Lunch
2:00 PM Error Analysis Error Analysis Error Analysis OFF Rapid Review
3:00 PM Error Analysis Error Analysis Error Analysis 44 Q’s Review Q’s
4:00 PM
5:00 PM Rapid Review Rapid Review Rapid Review OFF OFF
6:00 PM Rapid Review Rapid Review
7:00 PM Dinner Dinner Dinner Dinner
8:00 PM Cards Cards Cards Cards Cards Cards Cards Cards
Christine Santiago

 Attached are two schedules, a more detailed one with daily topics and another with general
schedules for planning the day. For the first month I spent half the day reading first aid/
watching pathoma for the subject topic. For the second half of the day I did q bank
questions, I tried to do 60 questions a day. I typically spent 2 days per topic, the first day
was more pathology, physiology and the second day I focused on pharmacology (a weakness
of mine).

 After I saw all the material once, I took an NBME to see strengths and weaknesses (NBME
16). The second month, I focused on weaknesses and q bank questions. I used my NBMEs
and UWORLD to locate my weaknesses and hit those topics the hardest. My NBMEs were
showing improvement however the last one I took 10 days before my actual exam, dropped
which threw me off and I considered postponing. After consulting with Rich and some
advisers I decided to take Step 1 anyway since I had an uptrend in the prior NBMEs, my
UWORLD percent was increasing and lastly because the field I wanted to go into (internal
medicine) does not require extremely competitive Step 1 scores.

 Resources:
1) Pathoma- went through once completely
2) Sketchy micro- went through once completely
3) UWORLD- went through once
4) NBMEs- timed- good practice for the actual exam. These under predicted my
actual score, the questions are easier than UWORLD and the actual exam but if
you're not in the top percentile I believe they under-predict your score (from my
friends scoring in the upper 240s and 250s their NBME scores were very close to
their actual scores).
5) Calculator for your STEP 1 score based on UWORLD percentage and NBME
averages (gives a predictor if you are concerned about what you'll actually get, my
score was within the standard deviation they predicted).
http://clinicalreview.com/ClinicalReview/resources/usmle-scorecalculator.html
6) Dirty USMLE- Fun videos for when you're too tired to read or do any more
questions.
https://www.youtube.com/channel/UCZaDAUF7UEcRXIFvGZu3O9Q/videos
Christine Santiago

 General advice:
 Figure out your Step 1 goal. What is a competitive score for the field you want to enter into? (Step 1
goals for a vascular surgery program vs internal med/ psychiatry are quite different).
 Try not to get discouraged if you are not scoring where you would like (easier said than done!)
 Consider doing Prometric Test Drive, this allows you to go to the testing center, check in with retinal
scans/ finger print and get a feel for the testing center. It helped reduce exam day jitters for me.
 Take breaks and maintain balance, I tried to take a half day off per week, Rich would probably
recommend more. In any event I did end up burning out during the last two weeks because I stopped
taking weekly breaks.
 Sleep: unfortunately I had some difficulty sleeping as I arrived closer to exam day and I think exam
anxiety affects people in different ways. As Brigham says, "never worry alone"! Reach out to Regina and
others if this is becoming an issue for you.
 Lastly, be careful where you stay before Step 1! I decided to study in Berkeley, California with my
significant other. The night before the exam we booked an airbnb close to the testing center to reduce
the commute. I woke up in the middle of the night itchy with bites all over and ended up finding a bed
bug! We had to pack up everything, find a hotel close by, it was a complete disaster. Moral of the story
be careful where you're staying before exam day and second remember even if you prepare completely
there are things that are outside of your control!
 "There are three elements to success: hard work, natural talent and luck. Unfortunately, we can only
improve the first."
 Good luck! Feel free to contact me if there is anything I can help with!
Laurie Schleimer
Schedule: no pre-made review calendar
My #1 piece of advice is that the best study strategy is the same strategy you've
been using for exams all along - I've never used study schedules/calendars before
and I didn't use one for step. I just studied as many hours per day as my brain
would work with these goals in mind:

1) make it through all of Pathoma watching 1-3 videos per day, then test myself on the videos I
just watched using a pre-made Anki deck I got from a friend
2) make it through all of UWorld, initially by taking subject-specific tests on what I had just
studied and later just by treating it as a textbook (i.e. take a test, and learn as I go)
3) make it through most of sketchy micro watching a section of videos together at a time (e.g. all
GNR one day, all RNA+ viruses another day)
4) make it through at least the autonomic drugs sections of sketchy pharm
5) review sections of first aid as they pop up on UWorld, and towards the end of the month go
through and fill any glaring gaps in knowledge

You should alternate between the different resources to mix things up and keep your brain engaged
during the day, and most importantly make time for exercise to reduce stress and keep your
brain going.
Location: NOT BOSTON
 I went home to stay with my parents and this was the BEST IDEA EVER - Avoided the stress of
being surrounded by classmates while having someone to make sure that you eat proper meals,
take breaks and--most importantly--exercise. I took the test in Boston.
Laurie Schleimer
Time: 5 weeks dedicated time, no prior review besides shelf studying.
Halfway through I contemplated changing my test day by 3 days to give myself more
time, but the final 3-4 days are the least productive because you just burn out on learning new
information. Only change your test day if you're trying to buy yourself weeks not days.

My days usually looked like this:

1-3 hours anki cards or Qbank
2-3 hours of video
5-8 hours of Qbank+reading - I could never sit down and just read FirstAid, so my
reading was always directed by doing questions. I would put Uworld in tutor mode and do a single
question, and if I got it wrong read on that topic and related topics. Then when I'd burn out on
reading about that topic I would go back to another question, and so on. This means at the
beginning it could take 6 hours to get though 40 questions and by the end I would speed through it
in like 2-3.
Severine Cao
 For resources I primarily used:
 - First Aid
 - UWorld
 - NBME Practice Exams
 - Anki

 I supplemented with:
 - Pathoma
 - Sketchy Micro
 - Notes from pre-clinical years
Severine Cao 8:00AM-12:00PM 3:00PM-6:30PM
AM
Week 1 Day 1 Monday 3-Apr Microbiology 65/Anki
Day 2 Tuesday 4-Apr Microbiology 65/Anki

Day 3 Wednesday 5-Apr Microbiology 65/Anki

Day 4 Thursday 6-Apr Biochemistry 65/Anki
Day 5 Friday 7-Apr Biochemistry 65/Anki
Day 6 Saturday 8-Apr UWorld Practice Exam- 1
Day 7 Sunday 9-Apr Catch-up 65/Anki
Week 2 Day 8 Monday 10-Apr Biochemistry/Immunology 65/Anki
Day 9 Tuesday 11-Apr Immunology 65/Anki

Day 10 Wednesday 12-Apr Pharmacology 65/Anki

Day 11 Thursday 13-Apr Pharmacology/Pathology 65/Anki
Day 12 Friday 14-Apr Pathology 65/Anki
Day 13 Saturday 15-Apr NBME Practice Exam- 1
Day 14 Sunday 16-Apr Catch-up 65/Anki
Week 3 Day 15 Monday 17-Apr Anatomy 65/Anki
Day 16 Tuesday 18-Apr Embryology 65/Anki

Day 17 Wednesday 19-Apr Embryology/Cards 65/Anki

Day 18 Thursday 20-Apr Cards 65/Anki
Day 19 Friday 21-Apr Cards/Endo 65/Anki
Day 20 Saturday 22-Apr Public Health Sciences/Endo 65/Anki
Day 21 Sunday 23-Apr NBME Practice Exam- 2
Week 4 Day 22 Monday 24-Apr GI 65/Anki
Day 23 Tuesday 25-Apr GI 65/Anki

Day 24 Wednesday 26-Apr Heme/Onc 65/Anki

Day 25 Thursday 27-Apr Heme/Onc 65/Anki
Day 26 Friday 28-Apr MSK 65/Anki
Day 27 Saturday 29-Apr MSK 65/Anki
Day 28 Sunday 30-Apr NBME Practice Exam- 3
Severine Cao

Week 5 Day 29 Monday 1-May Neuro 65/Anki

Day 30 Tuesday 2-May Neuro 65/Anki
Day 31 Wednesday 3-May Psych 65/Anki
Day 32 Thursday 4-May Renal 65/Anki
Day 33 Friday 5-May Renal 65/Anki
Day 34 Saturday 6-May NBME Practice Exam- 4
Day 35 Sunday 7-May Catch-up 65/Anki
Week 6 Day 36 Monday 8-May Repro 65/Anki
Day 37 Tuesday 9-May Repro 65/Anki
Day 38 Wednesday 10-May Resp 65/Anki
Day 39 Thursday 11-May Resp 65/Anki
Day 40 Friday 12-May Personal event
Day 41 Saturday 13-May Personal event
Day 42 Sunday 14-May Review 65/Anki
Week 7 Day 43 Monday 15-May NBME Practice Exam- 5
Day 44 Tuesday 16-May Review 65/Anki
Day 45 Wednesday 17-May Review 65/Anki
Day 46 Thursday 18-May Review 65/Anki
Day 47 Friday 19-May Review 65/Anki
Day 48 Saturday 20-May Review
Day 49 Sunday 21-May Try to relax
Day 50 Monday 22-May Test day!
Severine Cao

Question banks
UWorld Step 1 Qbank 2500 Q's
NBME Practice Tests x6 Each 200 questions in 4 sets of 50

Pathoma total 24.85 hours at

1.4x
Sketchy micro total 12 hours

Real exam
40x7=280 questions
Sean Fletcher
 Resources:
 First Aid Step 1 (2017)
 UWorld QBank (Including the two Self-Assessment
Practice Exams)
 Pathoma book and videos
 SketchyMicro
 NBME Practice Exams (All 6 that were available
online at the time)
 Week 1 Mon (4/3) Tues (4/4) Wed (4/5) Thurs (4/6) Fri (4/7) Sat (4/8) Sun (4/9) Week goals

Sean
Sketchy
UWorld 40q UWorld 40q UWorld 40q Uworld 40q Uworld 40q (Bacteria, Uworld 40q
8AM - 12PM Uworld Goal: 500Qs
Behav Sci Mixed Mixed Mixed Mixed Virus) Micro

Fletcher
FA Micro

12PM - 1PM Lunch Lunch Lunch Lunch Lunch Lunch Lunch

FA Behav Sci FA Immuno / FA Immuno/ Pathoma Ch3

FA Biochem Uworld 30q Sketchy
1PM - 4PM Pathoma Ch1 Pathoma Ch2 Pathoma Ch2 (Neoplasia) Pathoma Goal: Ch 1-3
(Mixed) FA Micro
(Growth..) (Inflamm.) (Inflamm.) FA Biochem

UWorld 40q
Micro cont. FA Goal:
4PM - 7PM Behav Sci / Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner
Dinner Behav Sci, Immuno, Biochem, Micro
Dinner
Catchup on
*NCAA Finals
UWorld 40q UWorld 40q Uworld 40q Uworld 40q Uworld 30q Micro
7PM - 10PM (finish Qs
Immuno Mixed Biochem Biochem (Mixed) (FA/Sketchy)/
after)
Relax
10PM - 12AM Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review Focus: Catch up on FA and Pathoma

Week 2 Mon (4/10) Tues (4/11) Wed (4/12) Thurs (4/13) Fri (4/14) Sat (4/15) Sun (4/16)

Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q
8AM - 12PM Practice Exam Uworld goal: 480 Qs (980 total)
Micro Micro Mixed Mixed Mixed Mixed

12PM - 1PM Lunch Lunch Lunch Lunch Lunch Lunch Lunch

Pathoma
Pathoma
Sketchy Micro Sketchy Micro Ch15
1PM - 4PM Ch7/8 FA Cardio Check Exam FA Endo / GI Pathoma: Ch7-8, 13-14, 15
/ FA Path / FA Pharm (Endo) / FA
(Vasc/Cardio)
Endo

Uworld 40q
4PM - 7PM Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Endo FA: Path, Pharm, Cardio, Endo, GI
/Dinner

Pathoma
Finish Uworld
Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Ch13,14
7PM - 10PM 40q
Mixed Mixed Cardio Cardio Endo (M/F Repro) /
Endo / Relax
Catchup

10PM - 12AM Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review Focus: Sketchy Micro

Week 3 Mon (4/17) Tues (4/18) Wed (4/19) Thurs (4/20) Fri (4/21) Sat (4/22) Sun (4/23)

Uworld 40q Uworld 40q Uworld 40q Uworld 40q

8AM - 12PM Practice Exam Alumni Wknd Alumni Wknd Uworld goal: 360 Qs (1340 total)
Mixed Mixed Mixed Mixed

12PM - 1PM Lunch Lunch Lunch Lunch Lunch Alumni Wknd Alumni Wknd
Pathoma
Pathoma Pathoma Ch Pathoma Ch6 FA MSK / Start
Ch18
1PM - 4PM Ch10/11 (GI) / 4/5 (WBC), FA Check Exam Alumni Wknd Uworld Mixed Pathoma: Ch 4-6, 10-11, 18
(MSK), FA
FA GI (PLT/RBCs) Heme/Onc 40q
MSK

4PM - 7PM Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Alumni Wknd Review/Din FA: Heme/Onc, MSK

Finish Uworld
Uworld 40q Uworld 40q Uworld 40q Uworld 40q 40q mixed /
7PM - 10PM Alumni Wknd Alumni Wknd
Mixed Mixed Mixed Mixed FA MSK /
Relax

10PM - 12AM Review/Relax Review/Relax Review/Relax Review/Relax Alumni Wknd Alumni Wknd Review/Relax Review Focus: Sketchy Pharm
 Week 4 Mon (4/24) Tues (4/25) Wed (4/26) Thurs (4/27) Fri (4/28) Sat (4/29) Sun (4/30)

Sean 8AM - 12PM

Uworld 40q
Mixed
Uworld 40q
Mixed
Uworld 40q
Mixed
Uworld 40q
Mixed
Uworld 40q
Mixed
Practice Exam
Uworld 40q
Mixed
Uworld goal: 460 Qs (1800 total)

Fletcher 12PM - 1PM Lunch Lunch Lunch Lunch Lunch Lunch Lunch

Pathoma Ch17 Pathoma Ch12 Pathoma Ch9

FA Psych / Pathoma
1PM - 4PM (Neuro), FA (Renal), FA FA Renal (Resp), FA Check Exam Pathoma: Ch9,12,16,17,19
Neuro Ch16,19
Neuro Renal Resp
(Breast, Skin)
FA: Neuro, Psych, Renal, Resp -- Finished 1st
4PM - 7PM Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Dinner/Relax
FA run through

Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld Mixed
7PM - 10PM
Mixed Mixed Mixed Mixed Mixed Mixed 20q / Relax

10PM - 12AM Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Relax Review Focus: Sketchy Pharm

Week 5 Mon (5/1) Tues (5/2) Wed (5/3) Thurs (5/4) Fri (5/5) Sat (5/6) Sun (5/7)

Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q
8AM - 12PM Practice Exam Uworld goal: 520 Qs (2320 total)
Mixed Mixed Mixed Mixed Mixed Mixed

12PM - 1PM Lunch Lunch Lunch Lunch Lunch Lunch Lunch

Sketchy Micro Sketchy Micro FA/Pathoma FA/Pathoma FA/Pathoma FA/Pathoma

1PM - 4PM Check Exam
/ FA Micro / FA Micro Weak Weak Weak Weak

Uworld 40q
4PM - 7PM Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Mixed FA Review Micro / Weak Organ Systems
/Dinner
Finish Uworld
Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q
7PM - 10PM 40q
Mixed Mixed Mixed Mixed Mixed Mixed
Mixed / Relax
10PM - 12AM Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review Focus: Sketchy Pharm

Week 6 Mon (5/8) Tues (5/9) Wed (5/10) Thurs (5/11) Fri (5/12) Sat (5/13) Sun (5/14)

Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Finish Uworld by Tuesday,
8AM - 12PM Practice Exam
Mixed Mixed (Finish!) Incorrect Incorrect Incorrect Incorrect begin Incorrects

12PM - 1PM Lunch Lunch Lunch Lunch Lunch Lunch Lunch

FA Biochem / FA Biochem /
FA
1PM - 4PM SketchyMicro SketchyMicro Pathoma Pathoma Check Exam Review
Embryology FA Review Basic Science / Weak Organ
Organs Organs
Systems
Uworld 40q
4PM - 7PM Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Incorrect
/ Dinner Pathoma Review Organ systems
Finish Uworld
Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q 40q
7PM - 10PM
Mixed Incorrect Incorrect Incorrect Incorrect Incorrect Incorrect,
Relax
10PM - 12AM Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review: Micro/Biochem/Immuno/Embryo
Sean Week 7 Mon (5/15) Tues (5/16) Wed (5/17) Thurs (5/18) Fri (5/19) Sat (5/20) Sun (5/21)

Fletcher 8AM - 12PM

Uworld 40q
Incorrect
Uworld 40q
Incorrect
Practice Exam
Uworld 40q
Incorrect
Uworld 40q
Incorrect
Practice Exam
Uworld 40q
Incorrect
Continue Uworld Incorrects

12PM - 1PM Lunch Lunch Lunch Lunch Lunch Lunch Lunch

1PM - 4PM Review Review Check Exam Review Review Check Exam Review
FA Review Basic Science / Weak Organ
Systems

4PM - 7PM Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner Review/Din

Uworld 40q Uworld 40q Uworld 40q Uworld 40q Uworld 40q
7PM - 10PM Review Review/Relax
Incorrect Incorrect Incorrect Incorrect Incorrect
Pathoma Review Organ systems
10PM - 12AM Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review/Relax Review: Micro/Biochem/Immuno/Embryo

Week 8 Mon (5/22) Tues (5/23) Wed (5/24) Thurs (5/25) Fri (5/26)

Uworld 40q Uworld 40q

8AM - 12PM Practice Exam Review TEST DAY! Finish Uworld Incorrects
Incorrect Incorrect

12PM - 1PM Lunch Lunch Lunch Lunch

1PM - 4PM Check Exam Review Review Review

Pathoma Review Organ systems

4PM - 7PM Gym/Dinner Gym/Dinner Gym/Dinner Gym/Dinner FA Review Basic Science / Weak Organ
Systems

7PM - 10PM Review Review Review Chill

10PM - 12AM Review/Relax Review/Relax Review/Relax Chill Review: Micro/Biochem/Immuno/Embryo

Sean
Fletcher
General thoughts
 1.) I almost always did Mixed UWorld blocks -- generally 80 questions a day, never more
than that but sometimes fewer. Some people preferred doing system based, but I liked
Mixed to have a random mix of topics to simulate the actual exam. I did not want to get
questions right based on knowing what block I was doing (For example, I found that it
was easier to eliminate non-cardio answers when I knew I was doing a Cardio block). I
did one pass through all of UWorld and then re-did my Incorrects afterwards. I did not
feel like I would have benefitted from doing another Qbank; UWorld is great.

 2.) I did a total of 8 practice exams -- 6 NBME and 2 UWorld Self-Assessments. I would
recommend doing as many exams as possible -- definitely all the NBME ones if you can,
because you may (read: will) see at least a couple of questions that are very similar on
the real test.

 3.) I did not stick to my schedule 100%. I tweaked things here and there as I found
necessary based on my strengths and weaknesses. I would leave a bit of time each day
or week for "catch-up" -- going through some First Aid or Pathoma chapters took longer
than anticipated. I would recommend making some sort of schedule and trying to stick
to it the best you can, but you will likely find that you need to deviate and tweak things
as you go along, which is totally fine.

 4.) I took a few hours each day to relax (an hour for lunch, 3 hours for gym and dinner,
generally stopped working around 11pm and relaxed afterwards), and usually took most
of Sunday evening off. If you have a fun event on a weekend or something, do it! Make
sure to remember that you're still a person outside of all the studying. Find something
that de-stresses you and take some time for yourself -- I watched Netflix almost every
day.
Sean
Fletcher
 5.) Try to prioritize the QBank each day. It's better to be behind on reading than behind
on questions.

 6.) I did one pass through all of Pathoma and the videos as well as one full pass through
First Aid. In the last couple of weeks I did another pass over the things I felt the weakest on
in FA / Pathoma.

 7.) Don't overwhelm yourself with resources. I had a few books (First Aid Organ
Systems, First Aid General Principles) and Flashcards (Microcards) that I never even
touched, but in the end I didn't feel that I needed them. Try to pick a few you like the best
and stick with them. It may take a little while at the beginning to get into a rhythm of
studying, but it will happen. Find a study buddy if that helps you, and by all means stay
away from people who stress you out!

 8.) Remember that there is truly an infinite amount of information. The test is unlike
many others in that you will never feel like you have totally mastered everything despite
putting in tons of hours over your study period. That's normal for everyone who takes this
test, though. Just try to learn as much as you can in the time you have. I felt that being on
the wards and having taken the shelf exams was a huge help for some of the clinical
knowledge the exam requires, so use that experience and knowledge as confidence when
you are feeling doubtful!
Extra Materials
Enrico Ferro

Lastly, if schedule allows, consider taking the tests back to back:

The two tests share many similarities, especially with regard to the vast amount of core
knowledge that you need to master for both of them. Whichever test you take first, you
will spend a lot of time solidifying the knowledge base so that you can immediately
recognize the disease process described in the question stem/vignette. Many questions in
both exams will ask you to diagnose the condition at hand; of course, step 1 will have many
more questions on the basic science of certain diseases, while step 2 will emphasize clinical
management. By taking the tests back to back, however, you will have the added benefit of
retaining and solidifying the core knowledge, without having to forget and re-learn all the
details. For example, think about congenital immunodeficiencies or lysosomal storage
diseases – which are not just part of step 1, and may in fact show up on the pediatrics
section of step 2.
Here is another example: