Step 1 Preparation and Experience

Step 1 Score 260+ My Complete Low-Stress Step Plan

Dedicated was 7 weeks (originally supposed to be 6 weeks, thankfully Corona did not affect or extend it that much)

My goal was to make dedicated completely just review. I wanted to “learn” very little new information in dedicated. I wanted dedicated to be as low stress as possible. I feel that the plan below prepared me to do so and get a score I am proud of.


I would say as a student I was always above the average of the class on the exams, but I would say everyone in medical school is of a certain similar intelligence and are all capable of receiving the same score I did on Step and higher!

Summer Before Step

I had planned to review physiology. I did review cardio and renal physio. I am glad one of my friends knocked some sense into me and said DO NOT DO THIS and just enjoy the summer. I feel the key thing to do in summer is Enjoy it. It’s hard to just accept being chill but do it! You will not regret it!! I actually regret the 2-3 days I canceled plans with friends to review that physio and wish I hadn’t – it really did not help, felt random and I just did that to ease my anxiety about relaxing.

If you feel huge anxiety about summer studying then maybe skim things you did horribly in, like if you failed something.

Fall Semester

Resources Used: First Aid, Pathoma, Sketchy Pharm, Anki

I read the first three chapters of Pathoma and watched the videos in the first month of school (August) and unsuspended the cards from the Anki deck.

In every block throughout the year, I would read the corresponding FA section and Pathoma section (and watch the videos). This was key. I really took no notes on anything. Barely annotated FA and Pathoma (I underlined just to keep focus, but nothing else beyond that—I found no benefit). I used Zanki and would make extra cards of things that were in FA but not in the Zanki deck or of questions I got wrong from Kaplan or UWORLD.

Another key!! was doing all the Sketchy pharm drugs of a block during that block. By the time I went into dedicated, I had already done all of the pharm and pretty much matured the majority of the sketchy pharm deck on Anki. This helped so much and pharm was never an issue for me on any of my practice tests. If your school has you moving through blocks starting in M1 that you will not revisit in M2 then I would try and just tackle those drug sections from sketchy pharm in the Fall as well and get them out of the way. In the Spring I only had the GI and Endocrine drugs left to do so I just did those with the corresponding blocks.

Questions: Kaplan and USMLERx*

I did most if not all the Kaplan questions associated with each block as I went through each block. Almost as a study tool for each block and really finished up the questions the week before the exam.

*I did some USMLERx questions too. In my opinion, you could just pick one. Unnecessary to get both unless you just want that extra practice.

Winter Break

Resources: FA, Anki, Sketchy Pharm Micro, and Sketchy Micro, UWORLD

My goal was to finish all of the Sketchy micro (including the micro drugs from sketchy pharm by January 31st) and unsuspend the sketchy micro from Lolnotacaps and Skethcy pharm micro deck as I went through them.

I got through most of the sketchy micro during winter break (like 12-ish days) but there was a lot of spillover into January. So I got through the rest of sketchy micro and sketchy pharm micro drugs after I finished the microbes by January 31st and met that goal. Spent the next few weeks after just maturing those cards in Anki

I started UWORLD in Winter break and did 40 questions per day on most days (maybe 200-ish questions done by the end). The UWORLD I did was micro and composed of sections of pharm and blocks I completed prior to Winter Break.

Spring Semester

I continued UWORLD, but I did probably 20 questions a day 4-5x a week (questions were random from all the blocks I had completed so far). My goal was to get through 50-75% of UWORLD before dedicated. I wanted to do UWORLD twice and I am glad that I did start earlier so that I was able to get this done. Many people will say this isn’t necessary but others will say they regret that they did not finish it twice. I will say I am happy that I did because I attribute my score to the very high # of questions I did. I also continued to use Kaplan to assess my understanding of the current block I was in in a more Step oriented way and continued to complete most of the questions for each block especially during the week before my exam for that block.

In February: Finished Immunology

Resources: Anki, BB videos, FA section

(I used the lightyear deck for biochem because it matched the BB videos better)

My goal was to finish all of the Immunology section since I wanted to get through it and master it before dedicated and I hadn’t seen it since M1. I was able to meet that goal and finish by March 1st and unsuspend the associated Anki cards and mature them before dedicated. It really took me only a week or so to finish the BB videos and FA section but took me the rest of the month to get through and try and mature the Anki cards associated with it.

In March: Finished Biochemistry

Resources: Anki, BB videos, FA section.

(I used the lightyear deck for biochem because it matched the BB videos better)

Again I wanted to go through and have biochem done well before dedicated. Biochem was not an issue for me at all coming into dedicated because of this. It was something I gave myself the month of March to master (understand and memorize (lol) when needed). I went through all the BB videos and FA chapter in one week and then spent the rest of the month doing Anki for it and touching up any concepts I did not understand or just needed to memorize. This helped significantly. I do not recommend leaving Biochem to dedicated. Upperclassman will have probably done that and been fine but why the added stress during dedicated? It was just a breeze through for me in dedicated and not a daunting thing to get through.

In April:

did all the random sections in FA for pharm and public health, and watched associated B&B videos when needed.

I also read through the anatomy pdf and did the associated Anki deck as needed (not all the cards, just cards I felt weren’t covered by the MSK deck in Zanki) this took like two days.


Did not use Anki for lecture info, just used it for each block I unsuspended all the cards and tried to get through all the Sketchy pharm and Zanki Deck for each block before the block ended. 

This was key.

What I would’ve done differently

Maybe would have started doing Micro earlier. Not for any other reason than giving me more free time in winter break to enjoy with family and friends. I do not think it would have affected my score.

Things I tried and dropped really quick

-watching BB for every block. I felt I didn’t need it so only watched videos for Immunology, Public Health, Biochemistry, and randomly throughout as needed for blocks.

-doing USMLERx in Spring—was unnecessary. No issue with this resource, but I think pick one extra resource – For me that was Kaplan. I know people who loved AMBOSS as their extra question bank.

-doing questions from other question sources, review books. I didn’t feel I needed it.


Just did a second round of UWORLD, Anki, redid pathoma videos (including Ch 1-3) and went through FA twice.


NBME CBSSA exam (administered by school): February 214

Form 21: 05/23/2020 – 246

Form 24: 05/30/2020 – 244

NBME CBSE (administered by school): 6/08/2020: 256

Form 18: 06/13/2020 – 255

UWSA2 06/20/20- 262

Free 120 06/21/20- 90%



This article was published with permission from the author

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