How I prepared for Step 1 of the USMLE
Resources I recommend
- First Aid 2013
- USMLE-Rx qbank (hereby referred to as “rx”)
- USMLE World qbank (hereby referred to as “uworld”)
Resources I DO NOT recommend
- Microbio made ridiculously simple – I didn’t like the text-heavy format. I could have just read First Aid, used flashcards, and done questions.
- Emory-specific: every module textbook except for Lily cardiology (First Aid and Wikipedia are sufficient to understand pathophysiology) are a waste of money
- Goljan is too dense and comprehensive; use Pathoma instead
- Robbins & Cotran is even thicker than Goljan!
- M2 ended on November 22nd, 2013.
- I took Step 1 on January 27th, 2014.
- This gave me 65 days (9 weeks, 2 days) to prepare.
- I took 8 days off to travel to California for a conference, see my family for the holidays, etc. This left me with 57 days (8 weeks, 1 day) to prepare.
- Realistically, I studied 5 to 6 full days per week, and used 8 weeks. This was a perfect amount of time. Less would be insufficient, and more would leave me burnt out.
- To maintain balance and optimize long-term focus, I recommend regularly exercising, sleeping 6-8 hours a night, and maintaining some social activity.
- I divided my studying into two phases: learning and question banks.
Phase 1 – Learning phase
- 33 days (4 weeks, 5 days), from 11/23/2013 to 1/5/2014.
- I reviewed First Aid 2013 cover to cover for a second time. This was not the first time, because I used First Aid 2013 as the framework from which I chose topics to focus my studies on during the modules. I chose to ignore our provided syllabi in lieu of material that was guaranteed to be high yield. I did not fail any module exams, and scored well on NBME exams. I highly recommend this. If I could go back, I would skip more lectures, study more First Aid, and do Rx or Firecracker as I went through M1 and M2.
- Each section took 2-4 days to complete.
- I read the material, then did module-specific Rx questions.
- I chose to learn with Rx (not UWorld) because Rx ties directly to First Aid.
- I only finished 40% of Rx; the goal was the reinforce learning of concepts via vignettes, not completion.
- My strongest sections: GI, pulmonology, psych.
- My weakest sections: microbiology, pharmacology, EBM (because we learned it so long ago), cardiology, neurology.
- I wish I spent less time on Learning and more time on QBanks
Phase 2 – QBanks phase
- 22 days (3 weeks, 1 day), from 1/6/2014 to 1/27/2014.
- Every day, I did UWorld blocks of 46 questions on all random (every topic in First Aid) in tutorial mode.
- I heavily annotated First Aid with colored pens and sticky notes.
- I left a dot next to the topic in First Aid so I would know which topics were heavily tested.
- The most common topics on UWorld were EBM, HIV, hepatitis, antiviral drugs, diabetes, psych drug side effects, P450 modulators, alpha and beta blockers, heart murmurs, IBD, … will update list later.
- I eventually switched from tutorial to timed, do a block or two, then review the answers later.
- At first, it took me a day (8 hours of studying) to answer and review two 46-question blocks. I averaged ~60%.
- I improved my speed to four 46-question blocks (if I focused hard). My average score improved to >70%.
- I finished all 2200+ UWorld questions a few days before I sat for Step 1. I then reviewed the questions I got wrong. I highly recommend this. Completion of a qbank builds confidence, even if retention is not 100%.
- I also took both UWorld diagnostic exams (blocks of 4 questions that give you a representative score). I am unsure if this was useful.
- I took Step 1 at a ProMetric center 20 minutes east of Atlanta, in Tucker, GA. I chose this location because I assumed a suburban area would have less traffic and easier parking than downtown Atlanta.
- I took a practice NBME exam at the test center a few days before Step 1. This helped me get a feel for the parking, building layout, security process, and computer system layout. I highly recommend this.
- On test day, I brought water, coffee, banana bread graciously baked by an M3 friend, and mixed nuts with dried fruits.
- I took two blocks of 46 questions, then a 5-10 minute break. I paced my caffeine intake and maintained hydration.
- I always finished every medical school exam and qbank block with time to spare, so I never worried about pacing. I usually finished a 46-question 60-minute block in about 45 minutes.
- No matter how well-prepared, you will become mentally fatigued after the 5th straight block of 46 questions. Slow down, stretch, take deep breaths, and stay focused.
- Answer every single question; guessing carries no penalty.