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Score Above 240 on Step 1 with the Best USMLE Study Resources

Dr. Tzvi Doron and Shelby Wood contributed to this post.
It never fails. A new USMLE Step 1 student shows up to our first meeting with a huge pile of books that would require Herculean strength just to carry, along with a slew of online video subscriptions and Qbanks for future use.

“What am I missing?” the student asks, concerned about forgetting the secret ingredient to acing Step 1.

I take 3 books out of the pile and leave all the rest. “You will use these 3 books, a Qbank, and almost nothing else. Trust me, you’re better off using fewer resources and mastering them than skimming over many resources and not knowing any of them well.”

At this point, I usually get a mixed look of relief and disbelief, and I often have to spend quite a bit of time convincing the student that all those extraneous resources are just not necessary. In the process, I then explain the best USMLE study resources and how to make optimal use of each one.

The key points of the conversation are as follows:

Fewer USMLE Study Resources = Better Performance

It is true of most things in life that the people who excel the most are those who master the basics rather than spending an enormous amount of time on minutiae with little pay off. The USMLE Step 1 exam is no different.

Although the exam covers a great deal of material, it is actually a pretty predictable exam. This means that most of your exam preparation time should be spent studying things you know are going to be well represented, or “high-yield,” on the exam.

There are a few study resources that have perfected the art of predicting what will be tested on the exam. These are the USMLE study resources that top scorers use and are the only study resources we recommend that every student use for Step 1 prep:

  • First Aid for the USMLE Step 1
  • UWorld question bank
  • NBME self-assessment exams

These resources will cover at least 90% of what you are likely to encounter on USMLE Step 1 and have been proven effective by tens of thousands of test takers over the years.

Note: Because a good understanding of physiology and pathology is required to perform well on USMLE Step 1, we often suggest BRS Physiology and Pathoma as well (but these are not required for every student).

These 5 resources are the absolute maximum amount of resources that most students should use.

Right about now, you’re probably asking how this could be possible. The answer is that the key to USMLE Step 1 success is not quantity of resources, but rather quality of resource use.

So, you may wonder, “Great! Now I know which resources to use, but how the heck do I use them?” I’m glad you asked.

First Aid for USMLE Step 1

Often referred to as “the Bible” (for good reason), First Aid for USMLE Step 1 should be seen as the backbone of your study program. Knowing this book cover-to-cover should be your goal, as it is necessary for achieving a good score on the exam.

First Aid outlines all of the high-yield material covered on Step 1, as well as some of the more obscure material that often shows up. The key to using this book is not just to read it, but to breathe it in and make sure you understand every last page of it.

This is done first by reading BRS physiology and using Pathoma to understand all of the material (often done during the first two years of medical school), and then by using First Aid to consolidate the material and memorize the details.

Flashcards will also be your best friend here. First Aid is a very dense book and flashcards will allow you to memorize the details found in First Aid by reviewing them over and over again until you own them.

You can create your own flashcards by hand if you’re old school, or by using online flashcard platforms such as Anki or Quizlet to type them up (NOTE: Beware the pre-made deck! While many of the decks floating around in online forums have often been vetted by hundreds of other medical students, student-made flashcard decks can still contain mistakes that you don’t want to memorize!).

A faster way to review First Aid in flashcard form is to invest in the USMLE-Rx Flash Facts deck, a page-by-page flashcard collection created by the writers of First Aid themselves that transforms the book into a digital flashcard deck that can turn your passive reading into active practice.

Practice questions will also help to bring the information in First Aid to life in a more clinical and contextual fashion, so let’s cover your best USMLE question bank now.

Avoid these top 5 mistakes when using First Aid for Step 1 prep!

UWorld: The Best Step 1 Qbank

Understanding the material presented in First Aid and memorizing the details will only get you so far. In order to do well on Step 1, you must be able to apply the material in the myriad ways you may confront it on test day. This is where UWorld comes in.

Of all the Qbanks out there, UWorld has the best proven record of helping students excel on Step 1. In our experience with thousands of students, we’ve found that UWorld’s question style is as close as it gets to the actual USMLE.

In addition, the difficulty level of UWorld questions is at least as hard, if not harder, than the actual exam. This builds confidence for test day and makes you less likely to freeze up when you get the harder questions on the exam because you’ll be prepared.

Lastly, one of the greatest assets of UWorld is the answer explanations. These are an essential learning resource, as they are well-written and cover every correct and incorrect answer in detail. If studied carefully, they can also teach you how to better dissect questions on the exam. 

To further enhance your understanding of UWorld’s answer explanations, many students opt to create flashcards of their incorrect questions using Anki or Quizlet.

While this can be slightly time-consuming, it can really help to hammer home the important details that you missed in each particular question that you got wrong. The flashcards don’t have to be long and complicated, simply include whatever fact you didn’t know that caused you to miss the question on one side of the card in one sentence or less, and put a fill-in-the-blank answer on the other side. If you can find 20-30 minutes to practice these flashcards daily, you will slowly see your areas for improvement turn into your strengths!

You should also consider making and using a UWorld Journal!

NBME Self-Assessment Exams

Would you go into any high stakes situation such as an important job interview without specifically practicing for it? Would you buy an expensive new car without taking it for a test drive first? Of course not! You want to be prepared for life’s most important moments by going through the motions in a lower stakes environment.

NBME self-assessment exams allow you to do just that by sitting for a half-length exam that very much resembles the actual USMLE Step 1. In addition, the score breakdowns allow you to assess your weak areas and, thus, to prioritize the subjects you need most to improve, which in turn allows flexible customization of your study plan as you go through it.

NBME assessment exams are also highly predictive of how well you will do on the real exam, thus allowing you to assess readiness to take the exam. We recommend that all students make extensive use of NBME assessment exams during their exam preparation (check out our NBME best practices post for a more in-depth look at NBME assessment exams).

What about all the other Step 1 resources?

We know that there are dozens of other resources out there covering parts or all of the USMLE curriculum. While these resources may be helpful at various points in your medical education, it’s best to streamline your studies and stick with these tried-and-true fundamentals during your dedicated Step 1 prep period so as not to become overwhelmed.

We’ve written reviews of some bonus resources, if you’re looking for supplemental study activities: