USMLE Prep Mailbag: Your Step 1 Study Questions Answered

  • /Reviewed by: Amy Rontal, MD
  • It’s that time of year. No, not the beginning of the countdown to the return of Game of Thrones. Rather, the beginning of your countdown to Step 1.

    Until now, your Step 1 approach was likely along the lines of “out of sight, out of mind”—but no more!

    Now is the time to stare down Step 1 like Jon Snow facing down an army of white walkers. So where do you begin? With good preparation of course!

    Do I really need to make a study schedule?

    Approaching Step 1 without a detailed study schedule is like going to the gym without a workout plan—rather than being efficient and getting jacked, you’re just going to spend 45 minutes running in place on the treadmill. Every student needs a detailed study schedule. Again, the key word is detailed. Simply listing off weekly tasks or big picture goals is not going to cut it. Instead, you should be making a daily schedule that outlines exactly what pages you plan to read, how much time you will be taking to read them, and how many UWorld questions you will be doing. The more detailed your schedule is, the more likely you are to follow it and to work at an efficient pace.

    A third year I’m friends with did really well on Step 1. Can I just use his/her schedule?

    Yes, you can use it—but only as an outline for how to make your own schedule. Remember, there is no one size fits all approach to Step 1 preparation. Your friend did not do well because of that specific study schedule; rather, they did well because they created a study schedule that addressed their individual needs and they stuck to it. Use their schedule as a template to ensure that you are addressing every aspect of the test; but, remember to modify it in order to fit your individual strengths and weaknesses.

    Should I start studying while finishing my second year classes?

    This question has been tackled in previous posts—but yes, you should. Take a realistic inventory of how you are currently spending your time and determine how many hours you have each day to devote towards USMLE preparation. I have never met anyone that has regretted starting studying during second year but I have met a lot of people that regret not doing it.

    I have the 2015 edition of First Aid. Do I need the 2016 edition?

    Yes. The new edition is designed to reflect changing trends on the test and often has many new pharmaceutical agents compared to the one before it. Always study with the most up to date version of any resource. The same is true for supplementary texts such as Pathoma and BRS Physiology. (Also, if you’re just starting med school, get ahead with an older copy of First Aid this way.)

    I am worried about wasting the UWorld questions now. What should I do?

    There is no such thing as “wasting” the UWorld questions by starting using them early in your second year. As long as you are pushing yourself to learn from each explanation and master the concepts, the question is never wasted. By the time you take your exam, your goal should be to have gotten through UWorld twice (generally speaking, once by system/subject, and the second time mixed/timed). If you finish this with more than 10 days before your exam, you can always consider adding a second question bank (here’s more on the Kaplan and USMLE Rx Qbanks).

    When should I take my first NBME? How many NBMEs should I take?

    If you have not done so already, I would recommend taking an NBME immediately in order to gage your current baseline and develop a rough idea of how long you might need to study for. From there, you should plan your schedule so that you complete every NBME available to you— preferably completing the final one 7-10 days before Step 1. NBMEs are incredibly valuable tools that can be used to identify and correct crucial weaknesses.

    Which flashcard service should I be using?

    As mentioned in previous posts, flashcards can be used to master memorizable content such as pharmacology, microbiology, immunology, and biochemistry. Additionally, they can be used to master other concepts in First Aid as well as for learning UWorld questions. We recommend that students use a digital flashcard platform that allows for spaced repetition. (We’re big fans of Memorang these days.) Furthermore, we encourage students to attempt to make their own flashcards. However, if you lack the ability or time to make your own flashcards, there are several high quality services available. These include the Brosencephalon deck available on Anki, Memorang, and Firecracker.

    Should I schedule my test so that I have some time off afterwards before 3rd year starts?

    Having some vacation time as a reward after your exam is nice—but it should not be your priority. If you do not think that you can perform well on the USMLE with an earlier test date, just avoid the vacation. You won’t regret it when you use that time to achieve a great score.

    When should I address my test-taking anxiety?

    Immediately. Tackling test taking anxiety takes time and may often require the help of a medical professional, tutor, and/or review course. If you feel that anxiety or poor test taking skills will negatively impact your score, then you should reach out for help as soon as possible. You want to give yourself as much time as possible to correct the underlying issues.

    I need an accommodation for the day of the exam, when should I request this?

    Immediately. Accommodations can take a significant amount of time to be granted and may require supporting documentation from your medical school and/or a physician. Get the ball rolling on this as soon as possible.

    As always, thank you for submitting questions and for giving me the chance to assist you in your USMLE preparation. Feel free to submit more questions online and please stay tuned for more USMLE mailbag posts throughout the next few months.