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First Aid: Five Best Practice Tips For “The Holy Book of USMLE Step 1”

Indiana Jones would never set out on an adventure without his hat and his whip, just as any self-respecting student embarking on their Step 1 studies wouldn’t dream of leaving USMLE World and First Aid out of the equation. Like any good adventure, you want a map to follow that shows you how to avoid the Indy-esque pitfalls. (Is that a rolling boulder of death behind you?) 

So, today, I want to go over some of the top methods you can use to maximize First Aid for the greatest returns in your Step 1 studies. Read on to learn more—but first, duck! Poison darts!


1. Purchase the latest edition of First Aid

Come on. You owe this one to yourself.

The editors of “the holy book of Step 1” work hard each year to update their material on the basis of students’ test-day experiences. We believe that truly mastering the content within First Aid, while easier said than done, can get most students to the 240+ range. If you’re using an old edition, you’re already starting in a hole.

You may have used, or even annotated, an older edition of First Aid early in your second year of medical school, and therefore may be hesitant about switching to the newest edition because you’ll lose all your old annotations.

We understand this completely and encounter it all the time. When I was in your shoes, I had the same worries. But the point I like to make with my students is that these annotations are likely to be less meaningful anyhow as you progress through the study period and begin to build deeper connections between various aspects of the material. This means that reviewing the older annotations amounts to wasted time in a sense because you’re so far beyond the content that you hadn’t quite mastered at the time you made those notes.

So don’t be that guy. Purchase the latest edition of First Aid.

2. Start early, but don’t make the mistake of relying exclusively upon First Aid during your second-year coursework

One way not to be overwhelmed with the task of tackling coursework alongside preparing to take the USMLE Step 1 is to befriend the Holy Book early and revisit it often throughout second year.

What does this mean?

During every block of material, you flip through the latest edition of First Aid to check that your curriculum is covering the core concepts. Look carefully for items not mentioned in class and see how they fit into the overall framework for that particular block of content.

What does this not mean?

Skipping all your classes and locking yourself in a room like a hermit.

Every year, second year medical students forgo attending lectures to cram in more hours with their First Aid. Don’t believe me? Check out this hilarious video made by the Albert Einstein Class of 2014 two years ago:

We think this approach is a bit misguided. Yes, lectures can seem time consuming. But they’re designed to give you the detailed and extensive backstory to the “essential facts” in First Aid. Going to lectures allows you to engage in various learning modalities, and will probably help place a lot of this information in context. Yes, it’s not always a high-yield use of time, but yes, it’s important.

Plus, human interaction is kind of nice.

3. Utilize First Aid based on your tried-and-true approach to learning new material

I strongly encourage my students to make notecards. This learning technique is FAR higher yield if it is initiated before your official study period begins since it is quite time-consuming to make so many notecards.

However, if you hate notecards, don’t force it. (I hesitate to say this, but I think this is an important point in general).

You should know by this point what type of learner you are. You’ve made it through several years of school, and this is far from the first standardized multiple-choice exam that you’ve taken. So don’t reinvent the wheel. What methods were useful when you prepared for other major exams?

Go ahead. Think about it a bit.

Are you a visual learner? I highly recommend multiple colored pens/highlighters.

Are you an auditory learner? I highly recommend incorporating Pathoma and/or Goljan audio files into your routine.

Are you a tactile learner? I highly recommend annotating and making notecards or small review sheets to reinforce core content.

Most people’s learning styles overlap a bit. You should be using a bit of all of these modalities as you approach this content. Starting earlier is more likely to yield good results, because it allows you to play around with the process a bit.

Not sure what type of learner you are? We’d love to help you figure out the best way to approach First Aid and the often-overwhelming process of preparing to take this exam!

4. Annotate, annotate, annotate (**a little dab’ll do ya)

In case you weren’t aware, I am going to say it forthrightly: You should be working through the USMLE World question bank and selectively annotating based on the explanations, especially for questions you don’t understand.

The problem comes when students take 6 hours to annotate the answers to 30 questions. If this is you, you’re probably overdoing it.

Everyone moves at different speeds, but for every hour you spend doing questions, a realistic amount of time to spend reviewing answers and annotating is approximately 2-3 hours.

5. Review

This is a LOT of information, even for professional multiple choice exam takers such as yourself.

Making multiple passes through First Aid doesn’t have to mean reading and re-reading. In fact, we strongly recommend against this passive learning approach.

Refer back to #3 here—we recommend notecards for everyone, but only YOU know what has worked for you in the past.

Then again, maybe you’ve never been quite comfortable with your study methods. Perhaps you have a hard time making or sticking to a schedule, or perhaps you struggle with using primarily passive learning modalities. Don’t fret. We’re here to help! If you think your approach could use some fine-tuning, our experts can’t wait to show you how to home in on high-yield resources, discover your best learning style and develop the ideal schedule to help you score high on Step 1.