STEP 1 Guide

Introduction

When you first confront the USMLE Step 1, you may find it all too easy to become sidetracked from your goal of studying with maximal effectiveness. Common mistakes that students make when studying for Step 1 include:

• Starting to study (including First Aid) too late

• Starting to study intensely too early and burning out

• Starting to prepare for boards before creating a knowledge foundation

• Using inefficient or inappropriate study methods

• Buying the wrong resources or buying too many resources

• Buying only one publisher’s review series for all subjects

• Not using practice examinations to maximum benefit

• Not understanding how scoring is performed or what the result means

• Not using review books along with your classes

• Not analyzing and improving your test-taking strategies

• Getting bogged down by reviewing difficult topics excessively

• Studying material that is rarely tested on the USMLE Step 1

• Failing to master certain high-yield subjects owing to overconfidence

• Using First Aid as your sole study resource

• Trying to prepare for it all alone

In this section, we offer advice to help you avoid these pitfalls and be more productive in your studies.

Understanding USMLE Step 1

The USMLE Step 1 is the first of three examinations required to become a licensed physician in the United States. It is a joint endeavor of the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB). The USMLE serves as the single examination system domestically and internationally for those seeking medical licensure in the United States.

The Step 1 exam includes test items that can be grouped by the organizational constructs outlined below (in order of tested frequency). In late 2020, the USMLE increased the number of items assessing communication skills. While pharmacology is still tested, they are focusing on drug mechanisms rather than pharmacotherapy. You will not be required to identify the specific medications indicated for a specific condition. Instead, you will be asked more about drug mechanisms and side effects.

Test at a glance:

• 8-hour exam

• Up to a total of 280 multiple choice items

• 7 test blocks (60 min/block)

• Up to 40 test items per block

• 45 minutes of break time, plus another 15 minutes if you skip the tutorial

Structuring Your Study Plan

Creating a well-structured study plan is crucial. Begin your preparation as early as possible, ideally from the start of medical school. Integrate USMLE review books into your daily studies to build a strong foundation. Use the following timeline as a guide:

1. Year(s) Prior: Use your coursework to build a solid knowledge base. Annotate high-quality review books as you progress through your courses.

2. Months Prior: Finalize your study schedule. Incorporate breaks, review periods, and practice exams.

3. Weeks Prior: Focus on intensive review and practice tests. Simulate the exam environment with full-length practice exams.

4. Days Prior: Ensure all administrative details are handled and engage in light review of high-yield material.

Selecting Study Materials

The selection of high-quality study materials is essential. Consider using a mix of stand-alone review books and series. Here are some recommended resources:

• U - UWorld

• F - First Aid

• A - Anki (AnKing)

• P - Pathoma

• S - Sketchy

• B - Boards & Beyond

• B - Bootcamp

• Practice Tests: NBME Comprehensive Basic Science Self-Assessments (CBSSA) and the free 120-question practice test on the USMLE website.

Effective Study Techniques

Adopt effective study techniques to enhance retention and understanding:

• Practice Testing: Use question banks to test your knowledge regularly. This helps identify weak areas and reinforces learning.

• Distributed Practice: Spread your study sessions over time rather than cramming. Spaced repetition is highly effective for long-term retention.

• Mnemonics: Create or use pre-made mnemonics for memorizing complex concepts.

• Elaborative Interrogation: Ask yourself "why" questions to deepen your understanding of the material.

Managing Exam Day

On the day of the exam, wake up at your regular time, eat a healthy breakfast, and arrive at the test center at least 30 minutes early. Bring necessary identification, your scheduling permit, and any allowed personal items. Dress in layers to accommodate varying room temperatures. During the exam, manage your time carefully:

• Pacing: Aim to spend no more than 90 seconds per question. Use any remaining time at the end of each block to review flagged questions.

• Breaks: Use your break time to rest and recharge. Bring snacks and water to keep your energy levels up.

After the Exam

After completing the exam, take time to relax and unwind. Reflect on your preparation process and consider sharing your insights with peers. If you do not pass, use the feedback from your score report to identify areas for improvement and plan your next steps. Remember, retaking the exam is a common part of the journey for many students.

Conclusion

Preparing for the USMLE Step 1 requires a strategic approach, effective study techniques, and the right resources. By understanding the exam structure, creating a detailed study plan, and managing your time effectively, you can maximize your chances of success. Stay focused, maintain a positive attitude, and remember that thorough preparation is the key to confidence and success on exam day.