As a new medical student trying to figure out how to succeed in their coursework many students will eventually face the same question: When and how do I start preparing for Step 1?

At first glance, there are two opposing answers to this question. Some will insist that you must crack First Aid open on day one, paying attention to your coursework only enough to pass your school’s exams. Others will insist that you put off any thought of the boards until the start of your second year.

Both of these camps have the same key flaw. They ignore the fact that your coursework preparation and preparing for the USMLE should be integrated.

The challenge in jumpstarting your USMLE prep lies in learning what information you must retain from your first year of coursework to set yourself up for success both in your second year of coursework and for the boards. There are a few key strategies that you can use to aid in this process.

How to Start Your USMLE Prep:

1. Figure out your learning style. It may have changed since college!

Somewhere around half your class will come straight from college, and another half will come from some number of years in the workforce. Either way, medical school is a whole different game from college, and stubbornly applying the same learning methods which have worked in the past may not be effective.

The first year of medical school is a great time to experiment with different tactics. Do you do better on exams when you have read every single piece of supplementary material?

Or do you do better when you have watched some Kahn Academy biochemistry youtube videos?

How do you do on exams when you attend lectures?

What happens when you mix it up and watch the recorded lectures?

Answers to these questions will be different for every student, but taking the time to figure out what works for you without being afraid to change up your routine will set you up for years of success. Check out our post on learning styles and USMLE prep!

2. Make notes or flashcards from each block that you can come back to and study.

Some students like to make flashcards.

Some students like to take fine detailed notes with fancy colorful pens.

Some students like to make giant posters detailing all the important biochem pathways.

The truth is, it doesn’t matter what you make, but creating some type of content that was made by your and for you is a powerful study tool. Any student coming back to review biochem in second year who prepared and studied by only reading the dense textbook will feel lost and daunted by the prospects of cracking that book open again.

Coming back to your own personally detailed notes will not only be a less overwhelming task, but it will be more efficient and help you remember more faster.

3. Do not try to learn from First Aid. Use it as your roadmap.

Many students make the mistake of trying to learn information from First Aid during their first year. This book was never intended for this purpose, but it still can be a useful tool.

Foregoing your gastroenterology lectures in lieu of the 20 page first aid section on GI anatomy and physiology won’t give you the depth of knowledge you need to understand the concepts. But, if you are wondering which enzyme names you really need to focus on during your GI block, reviewing what is mentioned in First Aid can prove useful.

Especially as you cover each subject in the general principles section, making flashcards from First Aid will help you identify what material is high yield and needs to be carried with you into second year, and what material was only covered to help you understand the depth and breadth of a particular subject, the details of which may no longer be needed.

While not strictly necessary, for the organ systems you can look at the First Aid embryology, anatomy, and physiology sections of each chapter, leaving the rest for second year.

Even better is to purchase a copy of First Aid Organ Systems which goes into more depth.

Avoid these 5 common First Aid mistakes!

4. Develop a method for spaced repetition

For me this meant using Anki Flashcards. Anki is a unique flashcard app that works on a model of spaced repetition, showing you flashcards over and over again, and spacing them out as they get easier.

You don’t have to use Anki, but it is essential that you revisit material throughout the year and don’t leave all of your immunology knowledge back in September of your first year. One of the great things about Anki is that once you get the deck set up, it will force you to mix it up every day by throwing a few flashcards in from subjects you covered months ago.

If you don’t use an app, you will have to do this on your own. Some students find it easier to set aside one day or one afternoon each week to review older material.

5. Know your CLINICAL anatomy

One of the hardest subjects to come back to in preparation for the USMLE is anatomy. There is simply so much material here that to cover it all in dedicated study time in your second year will prove nearly impossible.

Most students come out of first year with the most anatomy knowledge they will ever have. The more you know then, the more you will know come test day.

Unfortunately, this is not a situation where looking at first aid to see what anatomy is covered will prove useful. The best method to zero in on the high yield material will be to develop clinical correlations. Layers you will go through while doing a lumbar puncture? Definitely need to know that. The ability to identify the opponens pollicis muscle? You can probably forgo retaining that piece beyond your anatomy exam.

Read our post on how to study Anatomy in med school.

6. Experiment with Sketchy Pharm and Sketchy Micro

Sketchy pharm and sketchy micro are two very powerful learning tools, but they don’t work for everyone. They work based on the concept of image memorization and mind mapping, where you are able to remember different aspects of a drug or microbe by recalling an image full of symbols which represent different concepts such as gram positivity, susceptibility to certain drugs, or the presence of a bacterial toxin.

While this is a powerful learning mechanism that I have retained well beyond board prep and into my clinical years, it is a time intensive learning method that cannot be started during dedicated study, and must be revisited a few times before it is solidified.

To Sum it Up:

Overall, the best way to jumpstart your USMLE preparation, is to stop thinking of it as a separate thing that you do outside of your medical school’s curriculum.

The best way to prepare early on is to figure how to make your school’s curriculum work for you, by using the roadmap of First Aid to extract the high yield information. By using this framework you will be able to make the most out of your first year, learn what you need to learn, and set yourself up for second year and beyond while still succeeding on your first year exams!