Exam Preparation and Experience Step 1 Preparation and Experience USMLE General Advice USMLE Preparation and Experience

The United States Medical Licensing Examination – a Nigerian perspective – Dr. Chimezie Mbachi Bar’joe

Hi, I am Bar Joe, a graduate of the University of Nigeria, I started the USMLE process after graduation and I am currently in the interview process, at this point I decided to put this write up because I feel that the process can be made easier if we are being guided appropriately and if we start early enough to prepare. The aims of this write up are

🍁 Prevent people from making the same mistakes I made while preparing for the exam,

🍁 Try to help you understand the current state of the USMLE exams,

🍁 Encourage more Nigerians and perhaps Africans to attempt the exams and get very good scores

What is USMLE

The USMLE is the United States Medical Licensing Exam


Training in the USA offers better opportunities under the best of trainers so that you will be able to maximize your potential and be the best you can be.

How should I study for the USMLE

I believe that the study technique should focus on understanding concepts and could be achieved through Kaplan notes, Kaplan videos, UW questions, and first aid.

What I did was to start with Kaplan notes and videos subject wise so that I could have a general idea of the concepts.

Then during my second read, I read the Kaplan note, UW questions, first aid, subject wise for e.g, I read Kaplan physiology, UW physiology, first aid physiology then read Kaplan pathology, UW pathology, and first aid pathology and so on.

Repetition is the key.


I usually don’t like telling people the score to aim for but you should try to maximize your potential and get the highest score you can possibly get. The truth is that hundreds of applicants get 260s and 270s. To prove that you are better you need to score well above the average of the American graduates.

How Competitive Is The process

I will want every international medical graduate to understand that the process is extremely competitive and they are competing against the best in other parts of the world and they have a lot of factors against them (e.g. old Year of graduation, visa status, attending a medical school outside the USA etc). The only factor they can change is the score they get. To further buttress this point, I heard some programs receive as many as 5,500 applications for just 22 slots and more than 1,500 of the applicants score more than 240. This explains the need to get a very good score.

How Long it Takes To Prepare For Step 1

The duration of study depends on your IQ, when you graduated from medical school, the number of hours of study and the technique of study. It could range from 9 months to 1 year or more for step 1.

What factors decide whether I get a placement or not

Scores: It is the most important factor and probably one of the very few factors you can modify to get a placement. Other factors include your year of graduation, research, clinical experience, year of graduation

Can I get very competitive specialties

Yes, You can. Anything is possible in the united states even in Neurosurgery. But, you have to work very hard, you also need to get clinical experience and letters of recommendation in your preferred specialty. You need to also try to do electives, observership, and an externship in your preferred specialty.

What is the cost of the USMLE exams

USMLE Exam Fees – NBME

Will I be able to pursue this process, it is too expensive

I understand it is an expensive process, especially considering the current economic challenges. But you can reduce the amount of money you spend by getting very high scores, writing your exams once and planning.

Must I attend Kaplan live lectures

I believe the live lectures can help, especially if you need an academic environment or you need a student visa to come to the USA. But if you don’t have the money for the live lectures don’t feel bad as you can still get a very high performance but you will need to work harder.

Any Tips To Improve My Chances

✨✨ Form study groups.

✨✨ Start preparing for the exams as soon as you can, preferably during medical school and write the exam when you feel your NBME scores are more than your target score, but the earlier you write the better.

✨✨ Join USMLE facebook groups and USMLE forum online so that you can get the views of others in other parts of the world.

✨✨ Try to get involved in research projects both as a student,intern, and medical officer. You can meet your consultants and tell them that you are interested in being part of their research project.

✨✨ Try to publish your community health research project

✨✨ Always ask questions. NEVER DO IT ON YOUR OWN.

✨✨ Don’t fail any step, especially the Clinical skills exam, which is the easiest to pass, easiest to fail, most expensive and most distinct exam. MAKE SURE YOU DON’T SPEAK FAST IN THIS EXAM. You can improve your chances of passing by practicing online with a lot of people online via Skype and getting a tutor if you wish also try not to write the exam in Philadelphia.

✨✨ Focus on the deficiencies of your training. For me, it was behavioral sciences, statistics, and genetics.

✨✨ Don’t apply many years after graduation.

✨✨ Read your materials several times. If you need to read it 10 times to master it please read it.

✨✨ make friends with current residents in training.


Some people might need a tutor to maximize their potential. If you need a paid skype tutor please let me know. My email address is



Dr. Chimezie Mbachi Bar’joe

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