Let Us Do The USMLE Step 1 Planning (So You Don’t Have To)

  • /Reviewed by: Amy Rontal, MD
  • Let us do the planning so that you can do the studying.

    Taking Step 1 reminds me BASE jumping. The stakes are high. A great deal of time is spent selecting a site, planning an ascent, and making sure that every detail is accounted for to provide for a “safe” yet exhilarating jump. And then, just like that, you step to the edge of the cliff, look down, and prepare for the ride of your life.

    Standing at the cliff’s edge is a lot like sitting down into your chair at the testing center. The preparation has been intense, and a large part of your future depends on the quality of your prep work. Do you want to sit in that chair or stand on that cliff with the confidence and peace of mind that everything is optimized and success nearly guaranteed? Or will the test/jump begin with the thought “I knew I should have worked a little harder and been a little more efficient in setting up, but oh well, here we go!”

    Having a plan for USMLE studying is essential

    The thought of going into 5+ weeks of Step 1 studying without having a definitive road map for what subjects will be studied on what days makes me nauseous with anxiety. And it should make you nauseous, too.

    I’m sure you know the incredible bulk of material that you are expected to get through during your dedicated study period. It’s quite intimidating. You’ve got about 1000 pages of text, 2000+ questions to both answer and review. On top of that you probably have a system to use information from the questions to create more pages and flashcards to study from. You have less than two months to take the 2 years of facts, data, and information from your basic science classes, and build them into a well-organized fortress of knowledge.

    Getting from your first NBME practice test to the post-test celebration is a long road, and the success of your trip directly correlates with the quality of your plan.

    Here’s an example of what a detailed USMLE study schedule looks like. The level of detail might appear a bit over-the-top, but this is what’s necessary to be fully optimized on Test Day. Having your days laid out like this takes away all the guesswork. You will never need to ask yourself, “Have I covered all the material? Did I give Neurology enough time? Should I have put more effort into my schedule creation?”

    In a daunting, anxiety-laden vehicle like this 8-hour test that in many ways, determines your future, peace of mind is invaluable. Every ounce of grey and white matter that you can extricate from the “I hope I’m doing this right” thought pattern, and instead devote to studying proper, translates to points on the test.

    If you decide to go it alone, here’s some basic Step 1 prep guidelines:

    1. Put an NBME Self-Assessment on Day 0 of studying, and again at regular intervals throughout your study period.

    2. Get every subject that needs studying written out on a piece of paper.

    3. Divide your USMLE study schedule into two chunks, about two-thirds for your first pass and one-third for second-pass review.

    4. Evenly distribute the subjects to study over your first pass. It should turn out to be about 2 days on average; utilize less time (1-1.5 days) for more circumscribed subjects like psychiatry, and more time (3+ days) for behemoths like cardiology. Of course, the actual days will be based on whether your study schedule is 5 weeks or 8 weeks, or anywhere in between.

    5. Duplicate your first pass schedule overtop your second pass timeframe, dividing the amount of days in half. Keep this loose, as the first pass may highlight unexpected areas that require more or less time for the second go around.

    6. Take each day, and assign chunks of hours to an activity (reading a book vs. answering questions vs. reviewing flashcards). In general, somewhere around 3 hours should cover a full UWorld block; one hour for question completion and 2 hours for answer review. You don’t want to breeze through them too quickly, nor should you spend 4 hours on a single block.

    7. Put the plan into action, striving for the right amount of flexibility. Your plans are a guideline, and should be subject to change, but you definitely don’t want to fall more than 1 day behind.

    Someone else should look over this plan

    Independent double checks have their place in the administrations of high-alert medications and certainly have a place in Step 1 planning as well. Do you want to jump off that mountain assuming that you didn’t make any mistakes? Or would it be more prudent to have another set of eyes give you their vote of confidence?

    Comparing study schedules with fellow students can help to confirm that you are on the right track. Be judicious in your selection; an upperclassman who has been through this before and performed well on the test is a great resource. Hopefully your dean’s office also has faculty available to aid you throughout the process, as they’ve likely done for hundreds of Step 1-bound students in the past.

    We are happy to be that someone else

    MST offers specialized 1:1 consultation to help you in this crucial phase of your test prep. We can work with you to identify areas that need extra work, help you sprinkle those 1000 pages and 2000 questions across your weeks of studying, and be there to tell you that yes, it’s okay to take a day off of studying to go to your sister’s wedding. Our tutors have been through this wringer time-and-time again, and are happy to make resource recommendations, optimize your study calendar, and give you a vote of confidence when your plans look great.


    I can honestly say that having a firm plan to stick to was the most important factor in my own personal Step 1 success. We all know how to get information into our brains – it got us this far. But with a test as big in scope as this one, your road map is more essential than ever.