“Your Step 1 score is the most important part of your application.” For many medical students, this was the message we heard throughout our preclinical years. According to a 2021 NRMP survey, residency program directors cited USMLE Step 1 scores as the number one factor in granting an interview.

Now, you may be wondering: if Step 1 is pass/fail, how much does it really matter, and how much do I have to study?

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How Important is Step 1? 

We don’t have data yet about just how important a Step 1 pass is relative to, say, a high Step 2 score or a good personal statement when applying to residency. However, it’s clear from the 2021 NRMP survey that a failed attempt at a board exam is among the top five most important factors that residency programs take into consideration when deciding to interview candidates. For this reason, it’s much better to “overprepare” to guarantee a pass, instead of risking a failing score by shooting for a low pass.

With that said, studying for Step 1 is one of the most anxiety-inducing parts of medical school. If you are reading this after a failed attempt and are studying for a second or third time, do not despair. Board exams are just one of many components of your application, and creating a thorough, focused study plan can help you conquer Step 1. Read on to find out how! 

Step 1 Studying Begins Your First Day of Medical School

For most students, Step 1 is the most challenging board exam of your medical career. The sheer amount of information you must memorize is immense. This is why preparation actually starts in your preclinical years! If your preclinical foundation is not strong, you will have to essentially learn or relearn all the Step 1 information in your dedicated period, which is a daunting task.

In your first two years of medical school, you should be using a spaced repetition method to retain information. Spaced repetition through a flashcard program like Anki means that as soon as you begin to forget information, you are forced to recall it again. This has been proven time and time again to be the most effective method of retaining large amounts of information. Start early, and you will thank yourself later!

What is “Dedicated?”

After preclinical years, students take an average of 6-8 weeks of “dedicated” study time to prepare for Step 1. The amount of time you need will depend on your own weak points and your foundation of knowledge. The number one point to keep in mind is that your dedicated time should be as free of other obligations as possible! Do not take on extra research projects, and try to avoid scheduling big events such as weddings during this time. Your sole focus should be Step 1. 

Mapping Resources

A great way to start making a study schedule is to make a list of resources that you hope to get through by the end of dedicated. Blueprint’s Med School Study Planner is a smart study planner tool that allows medical students to create a personalized study plan in minutes to prepare for board exams including USMLE Step 1, COMLEX Level 1, USMLE Step 2, and Shelf exams. Blueprint’s Med School Study Planner has fully indexed hundreds of resources, so you can simply select the books, lectures, Qbanks, and flashcards you want to review for the exam. Then, it will map these resources as study tasks over a detailed schedule. If you fall behind, Blueprint’s Med School Study Planner will automatically redistribute the tasks throughout the study period with the click of a button.

If you find yourself devoting a lot of time to creating a study schedule from scratch, Blueprint’s Med School Study Planner may be a good option for you to spend more time studying rather than planning.

Which Study Resources Should I Use? 

From my own Step 1 tutoring experience of almost two years, as well as my experiences as a student, there are three high-yield Step 1 resources that will maximize your success on the exam. 

1. UWorld: This is the holy grail of practice questions and will make up the bulk of your study plan. Currently, there are about 3,600 questions on Uworld. An attainable goal is getting through 2 blocks of 80 questions per day. This means that, not including break days or practice exam days, you need at least 6.5 weeks of study time just to get through UWorld.
2. Anki: Continue your spaced repetition daily! Try to cap your flashcard time to an hour or two per day while in dedicated.
3. Practice exams: There are two UWorld practice exams (UWSA 1 and 2), and six NBME exams (NBME 25-30). Aim to take at least four practice exams throughout your dedicated period. Be warned: each one takes about a day of extra study time to thoroughly review!

Extra Resources For Content Review

Many students find they have weak points throughout their dedicated time that they need to brush up on. Here are a few resources that are incredibly effective for extra content review. While the bulk of your study day should be practice questions, you can supplement with these as needed.

1. 1. Physiology review: Costanzo Physiology. The subjects my students (and me!) struggle with most are cardiology, pulmonology, and renal due to the heavy physiology focus. This textbook makes these concepts much more digestible.
2. 2. Pathology review: Pathoma.
3. 3. Microbiology and pharmacology review: Sketchy Medical (especially if you are a visual learner).
4. 4. Biochemistry review: Pixorize.

Final Tips

Give yourself break time during dedicated! The students that burn out the most quickly are overambitious with their study plan and don’t build in breaks. Through my tutoring experience, the most effective break plans seem to be a break day after each practice test, as well as at least one half-day of a break per week. This means that in order to get all your content and questions done, and to have enough time for breaks, you should aim for an 8-week dedicated study period. However, your study days can (and should) start building your foundation much earlier than your dedicated period. The average Blueprint Med School Study Planner user spends 128 days studying for Step 1, which averages about 18 weeks total!

Step 1 is a daunting exam, but you’ve made it this far, and you can do it. Using the right resources can reduce your stress, and help you stay on track and perform well enough to land the residency of your dreams!