Exam Preparation and Experience Step 1 Preparation and Experience USMLE Preparation and Experience

My USMLE Step 1 Experience and Review by Dr. Sarah Brum


Step 1 score: 245

Dedicated study time: 8 months

First 5 months: 5-7 hours per day Next 3 months: 8-10 hours per day

Essential Resources
📚 First Aid (latest or recent edition)

📚 UWorld (6 months subscription with 2 Self Assessments)

📚 Pathoma (videos and notes)

📚 Biochemistry – Kaplan (Dr. Sam Turco’s lectures)

📚 Neurology – Kaplan (Dr. White’s lectures)

📚 USMLE Medical Ethics (Dr. Conrad Fischer)

📚 UWorld Biostats Review

Optional Resources
📝 Kaplan videos and lecture notes (2017 LN)

📝 BRS Physiology

📝 High Yield Gross Anatomy and Embryology

📝 Sketchy Micro (videos and images)

📝 Kaplan QBank for Genetics and Molecular Biology (half)

📝 Anatomy Shelf Notes

📝 Radiology and Heart Sounds – YouTube and Google

Kaplan Videos
Neuroanatomy: 2015 CA (Dr. White) Physiology: 2015 CA (Dr. Wilson) Neurophysio: BRS Biochemistry and Genetics: 2014 (Dr. Turco) Immunology: 2015 CA Pharmacology: 2010 (Dr. Raymon) Behavioral Science: 2010 (Dr. Daughtry)

My Timeline
⌛ First 2 weeks: Kaplan Biochemistry including Genetics (Kaplan)

⌛ Next 2 weeks: Pathoma (videos and notes)

⌛ Next 2 weeks: Physiology and Pharmacology (Kaplan)

⌛ Next 10 days: Revision + FA (system-vise)

⌛ Next 10 days: Immunology and Microbiology (Kaplan)

⌛ Next 10 days: Biostats & Behavioral science (Kaplan)

⌛ Next 10 days: BREAK

⌛ Next 5 days: Neurology (Kaplan)

⌛ Next 15 days: Kaplan (revision and stuff not done)

⌛ Next 2 months: UWorld (with loads of off days)

⌛ Next 20 days: FA Revision, offline NBMEs, remaining UWorld, Ethics book, UW Biostats

⌛ Next 10 days: BREAK

⌛ Next 1 month: FA, online NBMEs, UWSA 1, UW (second time)

⌛ Next 20 days: FA, Pathoma (second time), UWSA 2, remaining NBMEs, Ethics book, UW Biostats.

🎯 NBME 12 – 29 wrong (11 weeks prior)

🎯 NBME 11 – 34 wrong (9 weeks prior)

🎯 NBME 7 – 29 wrong (8 weeks prior)

Online NBMEs

🎯 NBME 13 – 25 wrong – 234 (7 weeks prior)

🎯 NBME 15 – 17 wrong – 250 (6 weeks prior)

🎯 NBME 16 – 17 wrong – 252 (4 weeks prior)

🎯 NBME 17 – 17 wrong – 246 (2 weeks prior)

🎯 NBME 19 – 22 wrong – 236 (10 days prior)

🎯 NBME 18 – 26 wrong – 242 (7 days prior)

💠 UWSA 1 – 251 (5 weeks prior)

💠 UWSA 2 – 254 (8 days prior)

💥 Sample 120 questions – 87% (10 days prior)

🔷 Kaplan Diagnostic Test: (After doing 25% of UWorld): 6/7/2017 57%

Exam Day

Stopped studying at 7:00 pm the previous evening. Watched quite a bit of motivating videos throughout the day to calm my nerves Slept for 7 hours, luckily soundly. Had a good breakfast and packed lunch, fruits, juice, and coffee with me. I had given an exam in the same center earlier, so I didn’t want to go for Prometric Practice Test. I would suggest it for those who want to get familiar with the process of giving there should go for it. Exam flew by. I checked the headphones and skipped the tutorial. Block 1 – break – block 2 – block 3 – break – block 4 – block 5 – lunch – block 6 – break – block 7

Some questions were easy, high yield, heavily tested. Whereas some could be only answered if concepts were clear. And some were bizarre. It’s quite unpredictable but all in all doable. My 6th block was very long and I ended up not completing it. I had a splitting headache and very slow reflexes. This exam does test your endurance and I would suggest giving 2 NBMEs/ 2 UWSAs together to simulate the exam timings. Plan the breaks before the exam, so that there is minimal improvisation during the test day.


Make sure you concentrate while watching Kaplan videos, so that you even if don’t come back to them, your concepts are completely clear. In my opinion, there’s no need to jot down Kaplan notes into first aid. You can always go back to your lecture notes during revision if you need to. Almost everything in UW is important. The explanation for the right and wrong answers and sometimes even the clues are given in the clinical vignette. Practically everyone says the first time UW should be done random, timed. I did half of it random, whereas I did few blocks subject-wise to finish off blocks quickly. It also helped to go through FA of that subject thoroughly during that block without having to constantly turn pages. While writing notes into FA, I used tons of post-its and practically used up most of the empty spaces. It’s time-consuming, so I wouldn’t recommend it. I suggest using another notebook or break the binding and file along with the notes. A really helpful tip I got from this forum was to type a word in the FA ebook first and then search it in the hard copy because searching by turning pages/ looking at the index behind takes a lot more time. I aimed at finishing a block a day. On some of my rare good days, I could finish 60 questions and on some off days, only 20. But no matter how long it takes, all 2400+ questions must be done at least once.

Some Words of Wisdom
💭 The most important thing. Set a target and BELIEVE that you will get it. Have faith that somehow with your hard work, with your patience, with your good days, even with your off days, you will reach your goal.

💭 Be grateful for whatever you’ve done up till the present moment. Trust me. I know I sound like most self-help books, but gratitude comes a long way. You cannot go back and get the time you lost so no time to brood about it, just be grateful for all that’s done even if it’s just a chapter. It’s a chapter less going forward.

💭 You cannot predict illness, emergency, moods, etc. so don’t punish yourself if you didn’t study as much. Move on and try to your best to catch up in the upcoming weeks.

💭 Always keep track of what needs to be done. Lists help me a lot, or if some of you manage to keep track in your head then that works too

💭 Cliched tip: Exercise. Especially your neck and back muscles.

What I could’ve Done Differently
🕓 I should have completed UWorld the second time. I got lazy and I felt that one time was enough. I gave more importance to redoing FA many times instead of doing UW again.

🕓 I should not have given myself too many off days. According to me more time you spend studying for this exam, the more you forget, and it gets easier to lose confidence. Just put your head down, study and finish it off.


Dr. Sarah Brum

🌿 Acknowledgement

Article published with permission from the author

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