How to Approach Step 1 Dedicated in 2022

  • Reviewed by: Amy Rontal, MD
  • If your (now pass/fail!) exam is scheduled in 2022, you may be wondering whether you need to be following conventional advice about Step 1 dedicated periods. Should you follow the detailed study calendars that abound online? Should you use the entire study period which your medical school has provided you? And most importantly: is it worth spending so much time preparing for this exam now that no numerical grade is given?

    In this post we offer some Do’s and Don’ts about how to build your study strategy in 2022!

    Do aim to be significantly above the passing threshold on your practice NBMEs

    Now that there is no numerical grade, it’s especially tempting to lower your guard. Still, full-length NBME practice tests are a necessary tool in this new pass/fail Step 1 world! They serve as the best indicator for whether you will indeed pass the actual exam. You will have a better chance to pass if you recreate the exam environment while studying. That’s why it’s especially important to take each practice exam under testing conditions (with minimal breaks and closed books).

    Although the practice tests may leave you stressed and exhausted, by accurately replicating the real testing experience you will make sure it’s not as new and stressful when the time comes to take the actual Step 1. Once you receive an estimated score, seriously consider the possibility that your score may go slightly down (as well as slightly up) on the real exam. Aim to take the actual Step 1 only when your practice exam scores are consistently, comfortably above the passing threshold. If you have time, try to take all available practice tests. Keep in mind that they are also a high-yield way to gain medical knowledge, which will better prepare you for rotations, as well as for your entire medical career.

    Don’t deviate too much from other well-established methods for success

    Although students may never again try to ramp up studying to increase from a 250 to a 260 during their final weeks of preparation, most aspects of Step 1 studying won’t change. During this inaugural year of a pass/fail Step 1 exam, you may be tempted to reduce the length of your dedicated study period or to follow a lighter schedule of studying.

    Remind yourself that passing Step 1 is a formidable goal by itself (and a wonderful accomplishment, once it’s achieved)! It’s best to follow the steps of those who came before you and to take advantage of the many study guides, calendars, and resources that were created when Step 1 was a graded exam.

    Do use the test’s pass/fail grading to help lower your anxiety

    Although you will continue to study for this exam as hard as the previous students did when it was graded, you can alleviate some of your stress by reminding yourself that your actual score will not be recorded as long as you pass. Use the new pass/fail scoring as motivation to feel more confident that you can master Step 1, as long as you stick with your efforts and continue to make progress!

    Don’t focus on merely passing Step 1 for the purpose of this exam only

    Keep in mind that you are not merely passing Step 1 to move on to the next step of medical school. You are also passing Step 1 to prepare for your time on clinical rotations, where you will be directly involved with patient care. All of your knowledge will come in handy when it’s time to  present on patients, write progress notes, or interview patients to fill in a history of present illness. In order to learn as much as you can in hospitals and clinics, and to prepare to be the best physician possible, it is especially crucial to approach clinical experiences with a wide, comprehensive knowledge base.

    Once preclinical, lecture-based courses are over, you will begin the life-long learning that a career in medicine always involves. As a clinical medical student, resident, fellow, or attending physician, no one will be directly tracking how much you study or what multiple-choice questions you can answer correctly; continuous learning is a personal responsibility (and privilege). And the earlier you start, the easier this path will be for you. 

    Do use the Step 1 experience to help guide your subsequent Step 2 experience

    Step 1 and Step 2 are unique in how they both involve weeks of dedicated studying, a couple thousand practice questions, and a large (large!) amount of content. Because of this, many students find that certain daily habits or study routines are useful additions to their typical patterns during Step studying periods.

    During your Step 1 dedicated study time, try different approaches: concentrated studying blocks, an exercise routine, or the pomodoro technique (worth checking out even because of its name!). Figure out whether you like to take notes as you complete UWorld questions and how you can learn most effectively. You will thank yourself later when the time comes to start Step 2 study period!

    Don’t try to cram in Step 2 studying

    Step 2 will likely increase in importance after Step 1 becomes pass/fail.Although the content of these two exams overlaps,  studying for Step 2 before taking Step 1 is not a great strategy. Step 1 is highly detailed and includes many subjects, ranging from biochemical reactions to immunological pathways and disease mechanisms. That is why you will likely need as much Step 1 studying time as you can get – and still won’t think it’s enough.

    Also, Step 1 and Step 2 assess fundamentally different aspects of medicine. The Step 2 exam emphasizes diagnostic reasoning and clinical management, whereas Step 1 emphasizes content recall and is more detail-oriented. Because of this difference, the way to approach Step 2 practice questions is drastically different from the way to approach Step 1 practice questions, and studying for both exams simultaneously may hinder your ability to hone test-taking strategies.

    Although changes are always challenging, you should know that your approach towards preparing for the USMLE Step 1 won’t change that drastically. The grading is now pass/fail, but Step 1 still is a milestone exam as well as your chance to build a firm base of knowledge that will come in handy many times during your successful career. 

    To take the stress out of prepping for Step 1, create a personalized study schedule that tells you exactly what to study each day so you can be confident you are on track. Get organized and sign up for a free trial account and create a custom Cram Fighter study plan in minutes now.