How I Scored a 790 on COMLEX Level 1, a 263 on USMLE Step 1, and Lived to Write This Blog Post

  • /Reviewed by: Amy Rontal, MD
  • In the past, we’ve recommended that most DO students not only take the COMLEX but the USMLE as well, which begs the question – how am I supposed to do that?? It’s no small feat, but as someone who has been through it and lived to tell the tale, I strongly believe that, with the right tools, anyone can succeed in these exams. In this post, I’ll share how I scored a 790 on Level 1 and a 263 on Step 1. Hopefully, some of the advice included below will help with your own preparations!

    The COMLEX and USMLE Mantra

    “Do what you ought, and put your heart into what you are doing.” ~ St. Josemaria Escriva

    So much of being successful rides on this quotation. It means actually sitting to study when you plan to instead of dilly-dallying around. It means putting your whole self into your studying: no cell phone, no emails, just the work. Concersely, it also means fully investing yourself in not studying when you have time to work out or have dinner with your friends. To prevent burnout, allow yourself to actually relax when you’re taking a break.

    Step 1 and Level 1 Resources

    If having a disciplined approach to your studies is the most important way to set yourself up for success, using the best resources and mastering them is a close second. Here’s what I used when preparing for Step 1 and Level 1, as well as how to use them effectively:

    • First Aid: this is your bible. Annotate missing concepts and facts from Pathoma and UWorld here.
    • Pathoma: use this during your pathology class and review during your dedicated study period
    • UWorld: complete at least one pass, ideally two
    • COMQUEST: I personally prefer this qbank over COMBANK, though UWorld is superior to both (even for people studying just for the COMLEX); finish one pass
    • OMT Review by Savarese: for OMM
    • Practice Tests (COMSAEs, UWSAs, NBMEs): take as many as you can. Do not sit for either Step 1 or Level 1 until your score is consistently where you want it to be. At minimum, you want to be scoring at least one standard deviation above passing.

    You’ll be all set if you master these resources and don’t stray too far from them. One of the most common downfalls for students is when they spread themselves too thin.

    A word about COMLEX-specific resources: to be totally honest, there are no solid ones out there. Most study plans for the COMLEX are essentially for the USMLE but with an added bit of OMM. While this can understandably be frustrating, in the end it doesn’t matter. If you are truly ready for the USMLE, you are ready for the COMLEX and vice-versa. The only outlier is OMM, which can be covered mostly with Savarese alone (you may also want to check out this post).

    There are also several “PRN” resources you can use as needed:

    • Memorang: great for memorizing small facts with which you’re having trouble
    • Picmonic: I used this for some things I was having trouble memorizing, like lysosomal storage diseases
    • DIT: if you can’t hold yourself accountable to sit and read First Aid for hours on end, this might be a good way to keep yourself on track
    • BRS Physiology: great addition if you’re having trouble understanding a particular physiology concept

    Again, beware of overusing these, as you don’t want to take too much time away from your core resources.

    Timing Your Exam Prep

    If you plan to take Step 1 the summer of your M2 year, start legitimately preparing after that Christmas break. Study any chance you can get, but don’t let the boards take you too far away from your coursework. Traditionally, those that master their classes do well on boards, as one feeds into the other; an easy way to take on both is to “double dip” when USMLE and COMLEX-relevant material overlaps with your courses.

    Once you hit your dedicated study period, you must study twelve hours a day. This may seem daunting, but it’s necessary. Study for twelve hours, sleep for seven, and use the remaining five for eating, relaxing, working out, etc. If you follow your mantra, it’ll be manageable.

    I suggest doing a final review of your entire annotated First Aid about a week before your exam, taking each day to review the concepts you find most challenging. On the final day, go through all remaining difficult material.

    If you’re taking Step 1, do so two days before you take Level 1 and cram OMM in the day between. This isn’t to say that you should not study OMM throughout your dedicated study period, but to try and memorize the small details again that day in-between exams. Any longer in-between the exams and you’ll go stir crazy.

    Spend the day before both exams doing something relaxing – you should stop studying by the afternoon. And don’t study the morning of your exams.

    Putting It All Together

    Preparing for the USMLE and COMLEX is stressful, so it’s important to have a strong support network. Remember to ask for help when you need it: call your mom or close friend to vent, go on a date with your spouse, take time to pray, etc. In the end, doing well isn’t just about mastering the right resources or staying disciplined and determined. No matter how easy it is to isolate yourself, make sure that you’re not going through this alone.