Step 1 Preparation and Experience

“It’s Always Omeprazole” – Step 1 Success Story by Dr. Mohammed Mustafa

Basic info

I am a sixth-year medical student, Al-Azhar University, new Damietta city. Egypt.

Preparation time: 9 months in 2017 and 5 months in 2015. With 1 year pause in between. Exam date: 13/9/2017 Result: 257


In the first 5 months in 2015, I used Kaplan videos 2010, along with Kaplan lecture notes (2015), Pathoma videos & text. In the 9 months of 2017: I used FA (2015? 🤔 Yes 2015!) along with DIT 2014 and USMLE-Rx question bank (solved almost 500 questions). This took me about 2 months. Then I used UW (system-wise) along with FA. I used to study a subject in FA then solved its relevant questions in UW. I had 74% right. This took me 2 and a half months. Then I did FA for the 3rd time…in about a month (yes, I am very lazy and after I finish something I take many days off 😄). Then I subscribed to UW online for 2 months. I used it for 1.5 months only and left 500 questions unsolved (I had 91% right). At that time, I did FA for the 4th time.

N.B. As you see I used the most usual materials, no odd stuff like Sketchy or Shelf Notes or Goljan, etc. I said this not to tell you they are bad or don’t use them (in fact, I know nothing about them!), but to tell you that it is not a must! You can score high without them. I am a simple guy, I chose the least number of resources possible. So, use those extra resources only if you think you really need them, not just because “Everyone uses them, so I must do like everyone does!”

As you see I did old versions in Kaplan and FA (2015). I had FA 2017 PDF but I didn’t use it very much. I guess 2015 was good. So, if you are going to start buying the newest FA, but if you already started with older version continue with it and have PDF for the new one just to be safe and not worry that you are missing something.

There are too many books and q banks; you can’t use them all. I know when you chose something, you will have the feeling that you chose the worst one and you are missing a good resource… NO! Just focus on the stuff you chose, you are not missing anything.

Always use questions with the study, always! Questions make you organize your mind and know the high yield parts.

In early stages, use Rx, because it is a fairly easy, then use UW. Only UW is like the exam, only UW will help you. I did a few Kaplan and Pastest questions… No, they weren’t like the exam at all!

Some people use offline UW. The good thing about the online version is that it has time! So, you can practice time management. Always solve 40 questions per set! Always 40 – no less!


In the following sequence (all timed except 13 and 16).

NBME 13 (5 months before the exam, online) –> 51 mistakes NBME 16 (3 months) –> 230. NBME 15 (2 months) –> 27 mistakes NBME 17 (2 months) –> 21 mistakes Then I did forms from 7-12 whenever I feel bored with the study, I didn’t have a particular pattern or so. I had 21-27 mistakes. In the last week I did one of the following per day:

UWSA 1 online — > 264 UWSA 2 online –> 251 NBME 18 offline –> 27 mistakes (244) NBME 19 offline –> 31 mistakes (227) Free 120 questions –> 87% N.B. – Do NBMEs as early as possible. Some people have a false belief that they are solved only before the exam… NO! …ONE BIG NO! Do them after you finish every stage in your study to know where you stand and how you progress.

Old NBMEs are just like new ones.

Offline NBMEs are like online ones, BUT they are not for assessment. As you see most of my NBMEs were offline, and I didn’t put the score beside them, just counted the mistakes. Offline is well as study material by living in the environment of the exam and pressure many times. Know where you are weak and strength it by using Pathoma and Kaplan. You can use other stuff like Google and Wikipedia, but I didn’t (I told my preparation was very simple).

First NBME will always be worse… don’t worry, we are all like this. The NBME has a different way of asking questions so first one may be odd to you.

You can use the first-time NBME in a non-timed pattern, but then you have to use it in a timed pattern.

Last Month… Last Week

So many people keep asking me how did you handle the last few months, weeks, days, or whatever. I will tell you something, I really opened the computer one day, looked at the date, and said WTF it is only 2 weeks to go!! 😱

What I mean is that I wasn’t really prepared, I put a plan and all this stuff, but I kept having the feeling that I still have time and I will make a one big Remontada better than what Barcelona did and I will master everything from the last stage… however, I found myself one day in the last stage!

I don’t recommend this of course, but I want to tell people who feel they haven’t done a lot, in the end, don’t worry, keep studying like you do, last days are not much different from other days.

Just make sure you repeat FA many times, master UW, and solve as many NBMEs as possible (all if you can).

Last week, I recommended one self-assessment a day. Don’t pay attention to details at this stage, just know the big picture and work on your mistakes.

Image for USMLE Step 1 experience by Mustafa

Last 2 days

I wasn’t studying in those days! To be honest, I reviewed Rapid Review at the end of FA and reviewed formulas (I had only one formula in the exam and it was very easy straightforward).

So, what I want to say is at this point study is over! What is done is done! So what should you do? You should plan for exam strategies. Like materials, you will take with you, have a hotel arranged if you will travel, relax and relax and relax.

For me the two days I finished the whole season 5 of the house of cards 😃.

If you are a coffee addict like me don’t drink them in those days to allow receptors to show up in your brain for exam day 😉

Night of the Exam

Again, no study! Travel early to the hotel if you will. Prepare your stuff, you will need only coffee, few sandwiches, and chocolate bars. Just take a small bag, prepare it next to your bed 😎

Again, relax, it is over now, anxiety won’t help you with anything except making you miserable.

What about sleep? Of course, it is obvious if you can sleep it is better BUT it is the most natural thing that you get insomnia at that night! Guys, we don’t have a switch button to make us sleep! So practice one or two weeks before to sleep early, but if you couldn’t don’t worry, many people got high scores without sleeping for 8 hours! (I know some people have that button and they can sleep at any time, those people… I will search for them… find them and Fu**en kill them).

The Day of the Exam

Ok, it is the day! The day that will determine your whole future, the day that will make you either happy or sad for the rest of your life 😰.

Let me tell you something, if you think like that on the exam day, then you are such a big loser and you will never get a high score!

Guys it is just another day, yes, it is important, yes it will affect your future, but it is not the end of the world! If you think your future is very fragile that it will be damaged by a 8 hour exam…. Then let me surprise you: you don’t have a promising future, and you do have a fragile one.

You are much better than this, much stronger than this.

So, with such mentality, you should start your morning. Wake up just 1 or 2 hours before the exam. Not more than this, remember you prepared everything last night!

All instruction will be told to you in the center from the moment you enter the center till you leave it 8 hours later. I used to think of them a lot and ask people to tell me what they did, but I find that it was easy and all self-explained.

So, you are waiting till they call your name, and you see other applicants like you, praying and crying and having some tremors like they have parkinsonism, and if someone approaches them they will shout and say leave me alone. When you see those, you should laugh inside and make sure that those guys will not get high scores. Just relax and have fun, I went to the cafeteria and drank a coffee and had joked with workers there (though they were angry don’t know why 😆).

They will call your name, you will enter the exam room, and suddenly you find a question in front of you! WTF just like that? Yeah, just like that. So, if you have anxiety, or you are not prepared enough (by solving as many NBMEs as possible) you will panic, and time will go like crazy, and you will finish the block with a lot of stress, the next blocks you will have time but you will be depressed. So, as you can see – it’s a sequence 🤓.

So, what should you do? Just relax. You did this many times before, remember exam is much easier than UW (Yay!!).

Never spend more than 1.5 minutes on a question whatever hard it is… NEVER!!!

The exam is like UW and 120 sample questions. With the oddness of NBME. All topics are almost from FA, but sometimes it is in a tricky way so if you can understand you will not have a problem. Many questions were the same as NBME. Many photos came from NBMEs but they ask something different.

I had many cardiology questions.

ANATOMY, really it will always be difficult, with many (but not all) questions not from FA or UW. You have no choice but try your luck! Don’t worry everyone will do like you. In fact, as you see in my performance I wasn’t very good at anatomy (and biostat). Biostat was easy, but I made silly mistakes.

Last 2 blocks are very hard, you will have diplopia like you have myasthenia Gravis. You will get a progressive headache like you have a brain tumor. So, take paracetamol before the exam. Remember before taking any drug too many times before the exam – you don’t want to have anaphylaxis in the exam hall and die there, you want to die in your house like any normal person do.

About clothes and breaks. They do a lot of things to you as if you are an ISIS member, but what I discovered that this doesn’t take so much time like people keep saying. Not more than 1 minute. So, don’t worry about that stuff. Time is more than enough, I had 3 breaks, and I had 30 minutes remaining so I could have taken 2 more breaks easily. I prayed, had lunch and coffee in the 3 times (yeah, I eat a lot like I have Prader-Willi syndrome).

After you finish exam, you will be very tired. You may have the feeling that you made a lot of mistakes. Very normal. Now go and sleep or play PlayStation or meet hot girls or whatever makes you happy, the damn exam is over! 😜

Image for USMLE Step 1 experience by Mustafa

After the exam

Ok, you can’t have fun. you can’t play PlayStation, you are miserable like me and can’t talk to girls. It doesn’t matter because you will always keep having flashbacks as if you have post-traumatic stress syndrome.

Importantly, you will have flashbacks to only the ones you did wrong. And you will say: omg! If these mistakes, only I remember what about those I don’t remember?!! “. We all have this feeling… Don’t worry buddy, this has nothing to do with your results. I got very simple questions wrong… like if they have asked me what was atherosclerosis made of — I answered protein instead of fat! If you ask 8-day old neonate with surfectant deficiency he will answer it right!

So, whatever you recall… It means nothing.

General points

  • USMLE is all about a condensed concentrated study (I had this one from TAt7). So, if you think the more months you study the more you score you are wrong.
  • People are different, many of the things I said here you can simply think they are stupid and don’t suit you. Ok. You are totally right!
  • Always choose Omeprazole
  • Don’t choose too many resources
  • At the beginning you will feel lost, you are not suitable for USMLE. It is normal. Just keep studying. In the beginning, you will think FA is a very bad book and Kaplan is much better. It is not. You will end up use FA. But don’t use it too early. Don’t annotate on it too early. Be patient.
  • Whatever plan you do, you will modify it at a certain point. Take this in mind.
  • Omeprazole is always the right answer, even if the patient has only fibroma on the little finger.
  • Luck plays a big role here. I could have had easily scored in the 40s or even 30s. I believe I was very lucky.
  • I know you read this now and then: “Wow this man is very confident, very smart, very sexy” (ok, probably you don’t see me sexy, but I like to think you do). My point is, everyone, tell his / her experience that looks confident and smart. But that’s because we finished the whole stuff. But when I have been in your stage just 3 weeks ago I was very anxious and did not have confidence and thought I am very stupid. At some point (and I swear that’s true) I thought I would fail!
  • So, if you feel you are not smart enough, watch out! Don’t be fooled by my false confidence, I was just like you or even worse! You will feel confident after the results, and you will get over 100 messages asking you to write your damn experience.
  • Many people feel bored, feel they don’t want to continue anymore, I am not suitable for this USMLE thing!
  • Well, you should know that this part of the journey. Like everyone had, have, or will have this feeling at a certain point in their preparation.
  • So, what should you do? First thing, to know that is going to happen anyway and happens to everyone.
  • Secondly, I highly recommend taking a day off in a week. And make this day constant. Make it totally free from study or any effort. Just for fun. I know it may not be a practical solution for some people, but I gotta say it helped a lot to evade boredom and misery.
  • If you feel bored, stop studying, and get back the next day! As simple as that.
  • It is always Omeprazole.


Mohammed Mustafa.

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