Are you starting to prepare for USMLE Step 1? If so, congratulations! Getting to this point means you’ve demonstrated strong preclinical knowledge. Now it’s time to pass your first USMLE so you can take the next big step on your journey to becoming a practicing physician!
If you’re nervous about Step 1, take heart: the pass rate in 2025 for all Step 1 test takers was 91%. So odds are, you’re going to be just fine!
That said, it’s important to prepare well, as almost all residency programs require you to pass the exam–and failing a USMLE exam will highly affect the strength of your residency application.
To help you prepare for the exam in a way that’ll set you up for success on Step 1 and beyond, I’ve come up with a plan that I think will help you crush it on exam day. Here’s the approach I recommend as a test-taker turned USMLE tutor.
Let’s dive in!
Looking for more personalized support while preparing for USMLE Step 1? We can help! Schedule a free consultation with a Step 1 tutor and get matched with an expert to help you pass the exam with flying colors (and set yourself up for success in med school & beyond)! 🚀
A 6-Point Plan to Help You Prepare for Step 1
As someone who has taken Step 1 relatively recently and helped students ace it, I’m here to help you by sharing my experience getting ready for the exam.
Preparing for Step 1 can be tricky because it’s pass/fail, and many students wonder if that should have any impact on their prep. My advice is to study for it like it’s still a graded exam. That’s what I did, which helped me better understand the material and set me up for success on clinical rotations, shelf exams, and Step 2. So I would recommend doing the same!
Here’s my six-point plan to set yourself up for success on USMLE Step 1:
1. Create your study schedule.
Calculate the amount of time until test day.
Before we get buried in the books, your first task is to calculate the amount of time you can dedicate to studying. My school allotted up to 10 weeks of dedicated study time for Step 1 before my preclinical years. I also wanted to spend some time relaxing before clinical rotations, so I chose to spend approximately 8 weeks studying for the exam and 2 weeks on vacation.
Determine the time you’ll devote to studying each day and consider personal factors.
After you know how many weeks there are until test day, determine the amount of time you can dedicate to studying Step 1 content each day. Having a dedicated studying period made it easier for me to dedicate 8-10 hours to studying each day. Be sure to bake at least one day off per week into your schedule to catch up on life and step away from studying. After all, life is more than medicine!
Additionally, consider other personal factors that could impact your schedule, such as weddings, familial commitments, and more. Think about how those personal factors will affect your day-to-day studying, and consider studying for longer on some days while having a lighter load on other days to balance studying with life.
Be sure your schedule includes a focused content review.
Many students find themselves forgetting content they covered early on in medical school, such as anatomy. We want to create an optimal schedule that plays to your individual strengths while tackling weaknesses (such as things you no longer remember or never understood). This will give you the best chance of passing Step 1.
Personally, I targeted areas where I may have memorized terminology but didn’t understand the underlying concepts (such as hematology/oncology) by rewatching Boards and Beyond and Pathoma videos while testing my knowledge with supplementary questions.
One of my biggest pieces of advice is to honestly assess your strong and weak areas. Think about subjects that were easier or harder to grasp in your preclinical years in medical school or—if you had graded tests in medical school—the exams where your score did not accurately reflect your confidence about the material.
Additionally, taking a Step 1 mock exam or practice self-assessment can also help you introspect while providing objective evidence to tailor your study schedule.
Once you’ve identified areas of improvement, find a resource to understand concepts you’re having trouble with, then test your understanding through Step 1 practice questions. (There will be more on this shortly).
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2. Pick your content review resources.
Choosing resources for Step 1 can be difficult, but it boils down to what works for you. You may already know your tried-and-true study materials that helped you do well in medical school. For me, I predominantly used third-party resources for most of my studying in my second year. I used Boards & Beyond for most of my foundational knowledge, Pathoma for pathology, and Sketchy Micro and Pharm.
Your resources may differ, but if they worked well for you during medical school, continue using those resources to brush up on content areas you previously identified.
If you’d like to switch things up, it may be helpful to talk to your dean or advisor to discuss how you learn and which resources suit your learning preferences. For example, some prefer visual learning and find that Sketchy works well, whereas others may prefer rote memorization through slide decks.
You can upload most content review resources into your personalized study schedule using Blueprint’s Med Study Planner. Try it now for free!
3. Use spaced repetition.
While content review is essential for reviewing core concepts, it’s also important to revisit material regularly during your preparation and do questions to test your understanding (discussed in greater detail below). Anki is a phenomenal resource that uses spaced repetition, which improves your long-term retention of material by reviewing it at increasing intervals, thereby thwarting the forgetting curve. I recommend the Anking deck, which includes material covered by most resources.
I used Anki during my second year and during my Step 1 dedicated study period. There were days when I studied Anki cards for up to four hours. If you’re not an Anki person, that’s completely fine! Think about what worked for you. Still, I’d strongly recommend incorporating spaced repetition into your study schedule in whichever format works for you.
4. Be an active learner!
Regardless of your method, it is important to engage in active learning, which means recalling knowledge instead of reading a textbook over and over (which is passive learning). For example, some students who don’t use Anki will create a summary note from lecture slides that contains key information. Then they revisit those notes at regular intervals, conceal the key information, and try to recall it.
5. Do Step 1 practice questions.
Now it’s time to put all that knowledge you gained during your Step 1 prep into practice! I completed around 80-120 Qbank questions per day and thoroughly reviewed them. As I reviewed each question, I tried to understand why each sentence was included in the vignette and how that related to the patient’s overall clinical picture.
Additionally, before I viewed the explanation, I tried to understand each answer choice and why I thought each choice was correct or incorrect. One question stem has a lot to unpack, so spend a good amount of time reviewing each question. I also created my own Anki flashcard deck that I used to revisit concepts from incorrectly answered questions, but you could use a spreadsheet if that works better for you.
Doing questions in this manner helped me consolidate my knowledge and develop critical thinking patterns that paid dividends not only for Step 1 and Step 2, but in clinical settings as well. Qbanks also helped me identify gaps in knowledge, which is especially useful if you believe you understood a concept but couldn’t apply it to a vignette.
6. Make final preparations!
With all that hard-work and preparation under your belt, it’s almost time to show off that knowledge! Leading up to the exam, attempt to emulate test day. A few days before my exam I woke up at approximately the same time I would on the day of the test. I ate around the same time and avoided any unfamiliar food or drinks. I also tried to relax a bit during this time.
The day before the exam, I prepared all the documents I needed to bring with me to the testing center and set them aside so everything was ready to go.
I didn’t study the day before the test (except for 30 minutes of quick review before bedtime on some last minute concepts).
As for trying to get to bed early, that didn’t work for me. Do it if you can but don’t be surprised if it’s not the best sleep of your life. After all, almost everyone has a restless night of sleep before Step 1. I certainly did!
Two Last Things to Remember!
1. Don’t skimp on biostatistics and social science material!
Per USMLE’s content guidelines, biostatistics, population health, and social sciences can comprise up to 15% of your exam. Don’t lose out on these points! Be sure to study this material and do some questions on it beforehand. Board & Beyond has a great review of biostatistics and AMBOSS has a great guide on ethical scenarios.
2. Feeling overwhelmed is normal.
At some point, you may be overwhelmed by the sheer amount of material to study or frustrated by a concept that is difficult to wrap your head around. Those feelings are normal! Trust yourself and be confident in your ability to do well on this exam. Having a positive mindset can really help you excel on test day.
Final Thoughts
If you made it through two years of medical school you’re more than capable of passing Step 1. That said, it’s important to prepare for the exam. Do so like it’s a graded test by employing the plan we’ve outlined here and you’ll not only do well on Step 1. You’ll set yourself up for success in the clinical years to come.
If you need some extra help along your journey, there are many Blueprint tutors available to assist you. They can help you break down difficult concepts or identify roadblocks that are standing in the way of your progress.
Remember, you’ve made it this far, and you got this! Good luck and reach out if you need assistance.
For more (free!) Step 1 content, check out these other posts on the blog:
