Step 1 Preparation and Experience

USMLE Step 1 258 Review and Recommended Anki Settings – Dr. Nour Moh

Salam Alaykum, I am happy to share my step 1 experience here with you guys. If you are dedicated and currently planning to sit for your step 1 exam in a relatively short period, then this post is for you! Feel free to ask any questions.

First advice, please start this dedicated journey by downloading 2 apps; Anki and a digital detox app (I used Flipd).

Anki is super beneficial and I will explain more how I used it, my settings, and how it helped me to excel promptly!

A digital detox app helps you to focus and avoid social media distraction that consumes your time and energy, you just keep scrolling down without any benefit, and afterward, you may feel drained and distracted. I used Flipd (on android app store), I started by complete lock mode for 4 hours then I escalated the lock period for 8 hrs then finally I went for 12 hrs of lock mode. I would say that was one of the most important things that helped me to concentrate on my study period and avoid any time waste.
My Timeline: 6 months (dedicated)


1- FA (The only book that I used; never used sketchy, pathoma, Kaplan, or any other book).

2- BnB (amazing source for beginners in the first round, I couldn’t finish it because of my tight schedule).

3- UW notes (I used old notes taken from UW 2016 then I found this great file here in the group and used it for a couple of chapters, I highly recommend it).

4- UW Qbank online: only once (Never used any other Q bank)

5- Anki (Anking V6 deck).


First Run

14 weeks (3 months and a half); 8-10 hrs daily undistracted study time.

Ø Resources: FA book (first read) + BNB + UW notes; with annotating in my FA book.

This was the hardest period in my preparation, items and concepts were brand new for me, let’s say most of us have weak basic knowledge especially in molecular biology, biochemistry in general, biostatistics, immunology, genetics, …etc. So what I did exactly was watching BNB along with FA for each chapter and taking notes in my FA (it’s time-consuming, but worth it), followed by reading UW notes for that chapter and taking more notes in my FA book. I didn’t have time to finish BNB, so the remaining chapters I just did FA and UW notes.

Second Run

8 weeks; 14-16 hrs daily undistracted study time.

Ø Resources: UW online + Anking V6 deck

I subscribed to UW online for 3 months. At this point, I felt I forgot every single word I studied (which was true and pretty NORMAL), so I decided to go system-wise, timed mode.

My daily plan was: Binge doing a chapter from the Anki deck (average 900 cards/day in 8 hrs in a row) then answer this chapter in UW (average 2 blocks/day in 8 hrs) and do UW flashcards of the wrong and marked Qs. Sometimes, I only had time to do Anki + answer 3-4 blocks in a day then review these blocks the next day (each UW block review took 3-4 hrs)
I didn’t have time to read FA again, but I read all the links in each Anki card (basically FA pages). Anki gives u > 80% of the information needed to answer UW correctly from the first time. My scores were high in UW blocks, most of them were between 85-95%, my final UW average score was 87.5 %.

Third Run

2 weeks, 16 hrs daily study time

Ø Resources:

1- UW flashcards (1200 total) cards: 8 days

2- Biostatistics UW review: 1 day

3- Anki Review of my weakest areas that I felt I forgot: Biochemistry and Neurology, each in 1 day.

4- Did the wrongs in UW of biostatistics and ethics (the ones I got the lowest scores in and not covered in my UW flashcards): 1 day

I took UWSA2 the day before my test and scored 262. I reviewed my wrongs and had a nice 8 hour night sleep and felt ready for the test.

Step 1 score card USMLE
Dr. Moh’s Step 1 performance

Regarding Anki:

Anki is ideally used for spaced REPETITION, so ideally it is useful to strengthen your long-term memory. It is better to start your journey with Anki daily. I used Anki once (ie; did new cards without reviewing) to break down the pieces of knowledge in each FA page into small parts and be able to memorize each line in FA efficiently. I was directly applying knowledge by answering UW afterward, that’s why I didn’t feel I need to do anki review of the chapters.

Anking V6 (now V7) is the best deck out there! Lolnotacop is the best for microbiology (Micro was the only chapter that I skipped first reading from FA at all, I just did Lolnotacop deck in 4 days along with UW.

My Anki settings:

1- Preferences: show new cards before review

2- My cards options:

  • 5 mins, 1 day (5 1440)
  • Order (show new cards in random)
  • Set a big number of new cards: 9999
  • Easy interval: 4 days
  • BURY related new cards(this setting is very important to avoid doing an extra similar 150+ cards a day, it buries related cards and saves ur time).
Recommended Anki settings
Recommended Anki settings USMLE

Final Thoughts:

It is NORMAL to feel lost and helpless throughout that period. DON’T GIVE UP!

Don’t worry about adjusting sleeping times: I started by waking up 6 am then ended by fulfilling a 16 hr study time, no matter what ( studied from 12 pm to 4 am). I adjusted my sleep hours only a couple of days before the test.

Do a self-assessment only when you feel ready.

The journey is hectic, tough, needs dedication, crazy effort, and a lot of prayers.

يجب ان نتحري اوقات اجابة الدعاء و خاصة في الثلث الأخير من الليل و نثق في الله و نتوكل علي الله حق التوكل.


Dr. Nour Moh

Other Step 1 Articles

Step 1 Review and experiences

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