Step 1 - 11/03/2025

Preparing for the USMLE Step 1 demands a blend of resources like UWorld, First Aid (FA), and NBME practice tests, which users across various posts rely on to build knowledge and assess readiness. Pathoma, particularly chapters 1-3, and Sketchy for microbiology and pharmacology are highlighted as high-yield tools to master critical content, while Mehlman PDFs offer concise reviews for last-minute boosts. Effective methods include starting with question banks to pinpoint weaknesses, followed by targeted content review with FA and spaced repetition via Anki. For international medical graduates (IMGs), opportunities like USCE can enhance residency prospects, ideally after passing Step 1. Tips such as prioritizing high-yield topics and resting before the exam underscore the balance between study and well-being.

The pass/fail nature of Step 1 shifts the focus to achieving a baseline competency, with NBME scores around 65%-70% serving as reliable predictors of success, as seen in posts where users debate postponing based on these metrics. Mental health emerges as a recurring theme, with advice to manage anxiety and avoid post-exam overthinking, reflecting the emotional toll of preparation and waiting periods. Posts from users who failed and retook the exam emphasize resilience, suggesting that a strategic review of weak areas—often using FA and pharmacology resources like Sketchy—can lead to a successful second attempt. The variability in exam difficulty, such as challenging neuro or communication questions, underscores the need for broad preparation.

In essence, Step 1 preparation is a marathon requiring strategic resource use, consistent practice, and mental fortitude. By leveraging tools like UWorld and FA, trusting practice test outcomes, and maintaining a healthy mindset, students can navigate the process effectively. The collective wisdom from these Reddit posts illustrates that while the exam tests medical knowledge, it equally challenges time management and emotional endurance, making a well-rounded approach essential for securing that coveted “P” on results day.

Resources

These are tools, materials, or platforms mentioned across the posts as aids for USMLE Step 1 preparation or exam-related processes.

• UWorld

  • URLs: Post 4, Post 6, Post 14, Post 24, Post 40, Post 43, Post 47, Post 57

  • Reason: Frequently cited as a primary question bank for practice and learning. Users discuss completing passes, reviewing incorrects, and adjusting strategies (e.g., random vs. system-based sets) to optimize preparation.

• First Aid (FA)

  • URLs: Post 4, Post 13, Post 16, Post 22, Post 24, Post 43, Post 48, Post 53, Post 57

  • Reason: A cornerstone resource for content review, often paired with other tools like UWorld or Pathoma. Users emphasize mastering FA for its high-yield content, especially in the final weeks.

• NBME Practice Tests

  • URLs: Post 4, Post 5, Post 7, Post 8, Post 9, Post 11, Post 16, Post 23, Post 24, Post 40, Post 41, Post 46, Post 47, Post 52, Post 57

  • Reason: Widely used to gauge readiness and identify weaknesses. Scores guide decisions on whether to proceed or postpone the exam.

• Pathoma

  • URLs: Post 9, Post 10, Post 24, Post 42, Post 48, Post 57

  • Reason: Praised for pathology review, particularly chapters 1-3, which are deemed high-yield and effective for score improvement.

• Sketchy

  • URLs: Post 12, Post 14, Post 17, Post 24, Post 55

  • Reason: Recommended for microbiology and pharmacology due to its visual mnemonic approach, making memorization easier.

• Mehlman PDFs

  • URLs: Post 5, Post 7, Post 9, Post 23, Post 24, Post 38, Post 43, Post 53

  • Reason: Targeted high-yield materials (e.g., arrows, risk factors, ethics) suggested for quick score boosts and weak area reinforcement.

• Anki

  • URLs: Post 5, Post 9, Post 23, Post 24, Post 43, Post 49, Post 57

  • Reason: Flashcard tool for spaced repetition, often paired with Sketchy or used for NBME incorrects, though some find it overwhelming.

• Boards and Beyond (BnB)

  • URLs: Post 13, Post 21, Post 43, Post 54

  • Reason: Video lectures for conceptual understanding, though some prefer it for specific topics rather than comprehensive use.

• Bootcamp

  • URLs: Post 13, Post 24, Post 55, Post 57

  • Reason: An alternative video series, useful for weak areas but less comprehensive than BnB for some users.

• Dirty Medicine

  • URLs: Post 12, Post 21, Post 24, Post 50, Post 54, Post 57

  • Reason: YouTube videos for quick, high-yield reviews, especially in biochemistry, ethics, and pharmacology.

• Amboss

  • URLs: Post 23, Post 38, Post 46, Post 53, Post 56, Post 57

  • Reason: Question bank and resource, particularly strong for ethics and clinical content, used by retakers and late-stage preppers.

• Pixorize

  • URL: Post 24

  • Reason: Visual mnemonics for biochemistry, immunology, and neuroanatomy, enhancing retention for specific topics.

• Randy Neil

  • URLs: Post 11, Post 24, Post 57

  • Reason: Recommended for biostatistics review, helping users improve a commonly weak area.

• USMLE Rx

  • URL: Post 52

  • Reason: Additional question bank used alongside UWorld for practice.

• Osmosis

  • URL: Post 53

  • Reason: Videos and articles for content review, suggested for retakers focusing on weak areas.

• Kaplan

  • URL: Post 53

  • Reason: Qbank and books recommended for retakers and clinical prep beyond Step 1.

Scores

These are specific performance metrics shared by users, reflecting their preparation progress.

• NBME Scores

  • Range: 48% to 77.5%

  • URLs: Post 4 (63%), Post 5 (59%-66%), Post 7 (67%-70%), Post 9 (48%-52%), Post 11 (62%-65%), Post 16 (54%), Post 23 (70%-85%), Post 38 (53%-68%), Post 41 (57%), Post 43 (66%-77.5%), Post 45 (53%-74%), Post 46 (68%-77%), Post 47 (71%), Post 52 (50%-63%), Post 56 (59%-71%), Post 57 (60.5%)

  • Reason: Reflects a broad range of readiness levels, with higher scores (e.g., 70%+) often linked to passing confidence.

• Free 120 Scores

  • Range: 69% to 76%

  • URLs: Post 7 (implied), Post 23 (83%), Post 38 (76%), Post 43 (71%), Post 45 (72%-76%)

  • Reason: Used as a final benchmark, with scores above 65%-70% suggesting readiness.

• UWSA Scores

  • Range: 56%-67%

  • URLs: Post 43 (67%), Post 57 (56%)

  • Reason: Self-assessment scores from UWorld, though less reliable than NBMEs per some users.

• CBSE Scores

  • Range: 52% to 69%

  • URLs: Post 7 (69%), Post 19 (62%), Post 38 (65%), Post 45 (66%), Post 55 (52%)

  • Reason: School-administered exams predicting Step 1 performance, with varying accuracy.

Methods

These are study strategies or approaches users employed or recommended.

• Question-Based Learning with UWorld

  • URL: Post 24

  • Reason: Starting with questions to identify gaps, rather than lectures, proved efficient for some.

• Content Review Using FA and Pathoma

  • URLs: Post 9, Post 43

  • Reason: Structured review of high-yield material to build a knowledge base.

• Reviewing Incorrects from Practice Tests

  • URLs: Post 23, Post 48

  • Reason: Targeting weaknesses by analyzing mistakes enhances understanding.

• Spaced Repetition with Anki

  • URL: Post 24

  • Reason: Reinforces retention over time, especially for micro and pharm.

• Simulating Exam Conditions

  • URLs: Post 14, Post 38

  • Reason: Random UWorld sets or Free 120 at Prometric mimic the real exam.

• Prioritizing High-Yield Topics

  • URLs: Post 10, Post 12

  • Reason: Focusing on frequently tested areas maximizes efficiency.

Opportunities

These are external factors or options that could benefit preparation or exam-taking.

• USCE for IMGs

  • URL: Post 15

  • Reason: Clinical experience in the US can enhance residency applications, ideally post-Step 1.

• Scheduling Flexibility at Prometric

  • URL: Post 24

  • Reason: Ability to adjust exam dates allows tailoring prep duration.

Tips

These are practical suggestions from users to improve preparation or performance.

• Focus on High-Yield Topics

  • URL: Post 12

  • Reason: Pharmacology and pathology (e.g., Pathoma 1-3) yield easy points.

• Manage Mental Health

  • URLs: Post 3, Post 53

  • Reason: Anxiety management is critical during prep and post-exam wait.

• Trust Practice Test Scores

  • URL: Post 38

  • Reason: Consistent NBME scores above 65% predict passing.

• Rest Before the Exam

  • URLs: Post 9, Post 54

  • Reason: A clear mind enhances performance on test day.

• Avoid Overthinking Post-Exam

  • URL: Post 45

  • Reason: Reduces unnecessary stress during the waiting period.

Tricks

These are specific techniques or shortcuts to streamline studying.

• Filter Anki Decks for Efficiency

  • URL: Post 24

  • Reason: Using NBME/UWorld tags reduces card volume significantly.

• Summarize UWorld Questions

  • URL: Post 24

  • Reason: One-sentence summaries capture key learning points quickly.

• Do Pathoma Early

  • URL: Post 10

  • Reason: Early mastery of chapters 1-3 allows later review, avoiding last-minute cramming.

Key Information

These are critical facts or insights about the exam or preparation process.

• The Exam is Pass/Fail

  • URL: Post 43

  • Reason: Focus is on competency, not numerical scores, reducing pressure.

• NBMEs Predict Readiness

  • URL: Post 7

  • Reason: Scores around 65%-70% correlate with passing likelihood.

• FA is Central

  • URL: Post 43

  • Reason: Most exam content aligns with FA, making it indispensable.

• Mental Resilience is Crucial

  • URL: Post 53

  • Reason: Overcoming failure or anxiety is as important as knowledge.

• Exam Variability Exists

  • URL: Post 3

  • Reason: Question difficulty (e.g., neuro, communication) varies by form.

• Time Management is Key

  • URL: Post 3

  • Reason: Long stems and tight block times challenge pacing.