INVISTA NO SEU SUCESSO:
Preparing for the USMLE Step 1 exam can be a challenging endeavor, especially after exhausting many primary resources. Based on shared experiences from various posts, a few key recommendations can help streamline your preparation and enhance study effectiveness. UWorld Self-Assessments (UWSA1 and UWSA2), alongside NBME forms, are popular and reliable predictors of Step 1 performance. These practice exams closely mimic the actual exam and can be valuable in gauging your preparation.
For those struggling with retention and revision, finding a balance between different study materials and methods is crucial. Using Anki to create filtered decks from UWorld questions has been recommended, as it helps reinforce concepts through spaced repetition. However, if Anki feels overwhelming, focusing on First Aid (FA) and specific resources like Dirty Medicine, which offers concise and high-yield notes, can be beneficial. Pathoma is another highly regarded resource for its clear explanations, particularly for pathology. For challenging subjects like biochemistry, Mehlman PDFs and Pixorize can offer targeted review materials that break down complex topics into manageable segments.
When planning your study schedule, dedicating specific time blocks to different resources can enhance productivity. For example, starting your day with a UWorld block, followed by reviewing FA, and ending with Anki or another question bank ensures comprehensive coverage of topics and better retention. Additionally, taking the Free 120 and its old versions can help simulate the exam day experience and identify areas that need further review. Balancing these various resources—UWorld, NBME forms, Kaplan/Blueprint exams, Dirty Medicine, Pathoma, and Mehlman PDFs—within a structured schedule can provide a robust preparation strategy.
In the final week before the exam, focusing on high-yield materials and effective revision strategies is essential. Key resources to consider are the NBME exams, Mehlman High Yield (HY) arrows, and Pathoma chapters 1-3. Revising NBME incorrects and focusing on NBME 26-31 and the new Free 120 if short on time is recommended. Utilizing review PDFs on your weakest topics and FA rapid review with a study partner can be incredibly beneficial. Engaging with Dirty Medicine and communications podcasts during daily activities like driving or cooking helps reinforce critical information effortlessly. To manage exam anxiety, practice exams in a simulated environment and consider consulting a healthcare provider about options like propranolol if severe anxiety persists. Balancing intense study with mental well-being is crucial, so integrate relaxation techniques and trust in your preparation as the exam day approaches.
A student preparing for the Step 1 exam in a month is seeking advice on additional assessments to take after completing all NBME forms and the Free 120. They have already taken UWSA1, scoring a 232, but face inconsistent performance in qbank blocks, ranging from 50% to 66%. They are considering revisiting old NBME forms and using free qbanks but are unsure if this is the best approach.
Respondents recommended utilizing Kaplan and Blueprint practice exams, which are noted to be closely aligned with the real exam. The advice suggests revisiting and revising the completed NBME forms instead of searching for new qbanks, ensuring a better grasp of previously learned material. First Aid cases textbook's mock exam was also mentioned as a useful tool for practice.
A user reposted their Dirty Medicine notes for Step 1 preparation, providing a document link for fellow students. The repost aims to help others with condensed and organized study materials, especially those looking for additional resources outside the usual Step 1 season.
The document was well-received by the community, with one comment expressing gratitude. No significant errors or corrections were noted in the responses, indicating the resource's reliability and usefulness for Step 1 preparation.
A student questioning their readiness for Step 1 shared their NBME scores, ranging from 67% to 72%, and sought advice on whether to proceed with the scheduled test date or reschedule. They are concerned about the reliability of CBSSA percentages and are contemplating the Free 120 as their final assessment before making a decision.
Advice from experienced test-takers suggested going ahead with the exam, emphasizing that consistent performance in the Free 120 (scores around 68-70%) is a good indicator of readiness. The respondents highlighted the importance of confidence and the trend of scores, suggesting that drastic changes in scores should be considered a red flag for rescheduling.
A student anxiously waiting for their Step 1 results inquired about the typical timeline for receiving scores after testing. They wondered if results could be expected two Wednesdays after their test date, seeking reassurance and experiences from others.
Responses varied, with some users indicating that a minimum of ten days plus any report problems could delay results. Others shared experiences of receiving scores unexpectedly early, two Wednesdays after testing, though this was not the norm. The consensus was to prepare for a longer wait and adjust expectations accordingly.
A student asked for advice on using UWorld filtered decks in Anki to reinforce question blocks and improve retention. They sought feedback from others who have used this method and how effective it was in their study process.
Commenters recommended utilizing Question IDs to unsuspend new information cards and suspend known concepts. Adding missing key points from UWorld explanations into Anki notes and highlighting important details was also suggested for better concept reinforcement. Overall, the approach was confirmed to be effective by several users.
A student preparing for Step 1 asked where to find offline NBME forms, expressing a need for additional study resources. They sought straightforward guidance on accessing these materials.
A responder suggested using the Telegram app to locate offline NBME forms, a common platform for sharing study resources among students. The original poster expressed gratitude for the assistance.
A student shared their frustration over a low score on NBME 31, feeling unprepared for the upcoming Step 1 exam and seeking advice on improving their performance. They detailed their extensive but seemingly ineffective study efforts and expressed a need for more efficient strategies.
The community provided comprehensive advice, emphasizing the importance of focusing on high-yield concepts and reducing the number of resources. Recommendations included prioritizing UWorld's 4 Ps (pathology, physiology, pathophysiology, and pharmacology), creating summarized Anki cards, and thoroughly reviewing old NBMEs with additional resources like First Aid. Reducing stress and improving test-taking strategies were also highlighted as crucial steps.
A student looking for a study partner for Step 1 preparation sought someone to help maintain motivation and track progress. They expressed the need for mutual encouragement and planned to take the exam by the end of the year or early next year.
Several users expressed interest, sharing their time zones and availability. The discussion led to the possibility of forming a small study group, emphasizing the benefits of collaborative study and mutual accountability in preparation for Step 1.
A student inquired about the possibility of matching into a residency program after failing Step 1 three times. They sought information on the likelihood of matching and whether taking the exam more than four times was possible.
Responses indicated that while matching with multiple Step 1 failures is possible, it is highly improbable and requires exceptional efforts in other areas, such as Step 2 scores, letters of recommendation, US clinical experience (USCE), and research. The consensus was that multiple failures significantly diminish chances, but some success stories exist, often involving perseverance and strategic application to less competitive programs.
A student asked for clarification on the versions of the old Free 120 practice tests, specifically the differences between the 2021 and 2022 versions and which one is commonly referred to as the "old" Free 120.
Community responses clarified that the 2021 version is considered the "old" Free 120 due to its lack of overlap with the newer 2022 and 2024 versions. This distinction is important for students seeking accurate practice without the risk of inflated scores due to repeated questions.
A student preparing for Step 1 is confused about which organ systems are currently considered high-yield (HY) for the exam, having seen varying opinions on the most frequently tested topics. They are seeking clarity on whether the focus changes and what the most current high-yield systems are.
Respondents pointed out that the USMLE Step 1 Content Outline and Specifications is a reliable source for understanding the test's structure. The exam covers various systems with specific weight ranges, such as Respiratory and Renal/Urinary Systems (10-15%) and Behavioral Health & Nervous Systems/Special Senses (10-14%). The advice emphasized a broad-based learning approach to cover all topics adequately as the specific focus might vary slightly between different test administrations.
A student six weeks away from their Step 1 exam expressed difficulty in managing their study resources, including UWorld, Anki, and First Aid (FA), while feeling overwhelmed despite studying for 10 hours a day. They sought advice on effectively balancing these resources and an example of a manageable study schedule.
Commenters suggested prioritizing UWorld and FA, as these are crucial for reinforcing key concepts. Anki, while useful, should be allocated to the end of the study sessions. Specific resources like Mehlman’s biochemistry PDF and Dirty Medicine for biochemistry pathways were recommended to quickly cover high-yield topics. A balanced schedule might involve starting the day with UWorld, followed by FA reviews, and ending with Anki to consolidate learning.
A student struggling with retaining cardiology concepts despite using Bootcamp sought advice on whether to use Mehlman’s cardiology PDF or to dive into UWorld and review First Aid (FA).
Advice varied, with some suggesting to start directly with UWorld to integrate learning through practice questions, while others recommended using Mehlman’s PDF alongside UWorld to consolidate difficult concepts. Pathoma was also mentioned as a valuable resource for in-depth explanations, but should be complemented with other resources for a comprehensive understanding. The consensus emphasized a combination of UWorld and FA as a solid approach to mastering cardiology.
A student with only seven days left before their Step 1 exam asked for advice on how to maximize their study time, including what to focus on and what to avoid.
Respondents advised against learning new material and instead focusing on revision. Reviewing NBME 31 and the Free 120 was highly recommended, along with high-yield topics from Mehlman’s PDFs and FA’s Rapid Review. Other helpful suggestions included watching specific videos like HyGuru MSK Anatomy and Dirty Medicine for biochemistry and biostatistics, ensuring to go over incorrect NBME questions to solidify understanding.
A student questioned the efficacy of reviewing old NBME forms in their preparation for Step 1, seeking opinions on whether this strategy helps in identifying recurring concepts and improving performance.
Most commenters strongly supported reviewing old NBMEs, citing that many test concepts are repeated, which helps in familiarizing with the exam's style. One user shared their method of creating a detailed document from NBME reviews, which was crucial in passing Step 1. Another emphasized the importance of focusing on NBME 26-31 and the Free 120 due to their closer alignment with the actual exam. The consensus was that NBME reviews are more beneficial than additional UWorld questions towards the end of preparation.
A student experiencing severe testing anxiety noted significant score drops when taking proctored exams compared to home practice tests. They sought advice on managing this anxiety during the actual exam.
Suggestions included replicating the test environment by taking more proctored practice exams to build familiarity and reduce anxiety. Physical strategies such as considering propranolol, which can help manage physical symptoms of anxiety, were also mentioned, though it was advised to try it during practice rather than the actual exam. Ensuring consistent test-taking conditions was highlighted as a key strategy to mitigate anxiety.
A student expressed frustration with the recent update to Sketchy Medical, highlighting issues like videos marked as "in progress" instead of completed and a more complicated navigation system.
The update was widely criticized in the responses, with users lamenting the loss of the quiz feature, the 10-second rewind button, and bookmarks. Many students noted that these changes disrupted their study flow, especially during dedicated study periods. Some users recommended emailing Sketchy's support team to voice complaints, hoping for a reversion or improvement of the update.
A student asked whether they need to use Mehlman PDFs for Step 1 preparation, given that some content is tailored for Step 2. They sought guidance on how to effectively use these PDFs and whether they should annotate in First Aid (FA).
The primary advice was that solid preparation for Step 1 inherently prepares students for Step 2. Thus, all material in Mehlman PDFs is valuable. Annotations in FA were recommended to consolidate and cross-reference key concepts, making the review process more integrated and comprehensive.
A student asked why stroke volume (SV) increases with age despite the increase in systolic blood pressure (afterload) and decrease in diastolic function (preload). They cited a source suggesting an increase in SV, which seemed contradictory to their understanding.
Respondents clarified that stroke volume typically decreases with age due to the heart's reduced compliance and increased afterload. However, the link provided might be interpreting specific contexts or relative comparisons. Some explanations considered the possible increase in SV due to age-related bradycardia, leading to longer diastole periods. The discussion highlighted the complexity of cardiac physiology and the need for careful interpretation of medical literature.
A student asked whether the Free 120 practice test is more representative of higher-order questions compared to the NBME forms, which are known for their straightforward first and second-order questions. They sought clarification on the nature of the questions in Free 120 and how it compares to other practice resources.
Respondents highlighted that the Free 120 is indeed a mix of various question types, similar to the actual Step 1 exam. One user who recently took the exam noted that the question stems in Free 120 and UWorld are comparable, often being even longer, while the answer choices and concepts are closely aligned with NBME forms. The consensus was that Free 120 is a valuable resource that accurately reflects the complexity and style of the real exam, making it an essential part of a comprehensive study plan.
A student diagnosed with ADHD during medical school sought advice on how to structure their personal statement for Step 1 accommodations. They inquired about the necessary documentation and how to present their case effectively, especially without previous accommodations.
The advice centered on being detailed and thorough in the personal statement, clearly outlining how ADHD affects their test-taking abilities and daily functioning. It was suggested to include results from neuropsychological testing as supporting documentation. Emphasizing the diagnosis process and how accommodations would help level the playing field was also recommended. The goal is to present a compelling case that demonstrates the need for accommodations based on well-documented evidence.
A student asked if the old Free 120 practice test is available online in a format that provides a percentage score, similar to the new Free 120 and NBME forms. They wanted to know if this resource is accessible beyond just PDF format.
Responses confirmed that the old Free 120 is only available in PDF format and not in an interactive online format. A helpful link to the PDF was provided, but it was clarified that there is no way to obtain a percentage score directly from the document. Students can manually score their practice tests by using the answer keys provided within the PDF. Despite the lack of an online version, utilizing the PDF is still valuable for practice and review.
A student inquired about how to use Mehlman PDFs effectively for Step 1 preparation, asking which PDFs are essential and when to integrate them into their study plan alongside UWorld and First Aid (FA).
The responses advised integrating Mehlman PDFs concurrently with UWorld, focusing on high-yield documents such as HY arrows, HY biochem, HY immuno, and HY neuroanatomy. Additionally, it was recommended to review the ethics and risk factors PDFs closer to the exam date. The use of Mehlman’s resources is to reinforce concepts learned from UWorld and FA, providing a solid foundation and boosting scores by targeting specific high-yield areas. A strategy combining these resources ensures comprehensive coverage and better retention of critical information.
A student questioned whether they need to use all of Mehlman’s PDFs for Step 1 preparation and sought advice on which ones are most critical for success.
The overwhelming response emphasized that while all Mehlman PDFs are beneficial, the most critical ones for Step 1 include HY arrows, HY biochem, HY immuno, and HY neuroanatomy. These documents are known to significantly boost scores by focusing on high-yield content. It was suggested that students prioritize these if they are short on time. However, those who have ample time should consider going through all the PDFs for a more comprehensive review. There was no need to annotate these PDFs in FA, as Mehlman’s resources are meant to complement the main study materials.
An international medical graduate (IMG) planning to take Step 1 in July 2025 asked if they could apply for ECFMG certification with an expired passport and what issues they might face if they renew it later.
The primary advice was that an expired passport is not valid for ECFMG certification application. The student was advised to renew their passport before starting the application process to avoid complications. While applying with an expired passport might seem expedient, it could lead to issues during registration or on exam day. The suggestion to contact ECFMG directly for the most accurate guidance was also provided, ensuring that all requirements are met without risking delays or rejections.