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USMLE Step 1 Prep & Med School Coursework: Two Great Things That Go Great Together

Whether you are just starting up your second semester of medical school or knee-deep in second year, you’ve probably started to think about that next big hurdle: Step 1. Not only do you need to pass to become a doctor, but a good score can open doors to competitive residency programs while a poor score can close them. With so much weight placed on a single exam, you would expect programs and lecturers to emphasize the material tested on this end-all-be-all test. In most cases, you would be wrong. While some programs provide a bit more Step 1 focus in courses, many teach details that are tangentially relevant to Step 1 topics, but miss key points that are frequently tested, often referring students to review this test material during their dedicated study period. And it can be frustrating! You’ve made it this far by thinking ahead, planning early, and trying to avoid cramming unless absolutely necessary. Why should this be any different? So as a student, you may be faced with a difficult choice: study for your courses or study for Step 1. But there are effective and efficient ways to begin preparing for Step 1 well before your dedicated study period, while incorporating material that will be tested on course exams. Here are some key tips for beginning your Step 1 prep during your coursework:

1. Start exploring Step 1 resources during the corresponding course.

Starting a cardiology unit? Diving in to microbiology? Find the top rate Step 1 resources for that subject and take a few hours to try them out. As you’re investigating ask yourself: Does this overlap with topics on my course schedule or syllabus? Is this redundant with another resource I already like using (see Rapid Review Pathology vs Pathoma)? Am I actually able to learn from this resource? Because there is so much variety, it’s important to invest time early to find what works for you. You may find resources like Sketchy Med work really well for you. If not, don’t fear! There are plenty of alternative resources. Don’t force yourself to use something that doesn’t gel with your learning style. Once you’ve found a resource or two that you like for your course…

2. Use your favorite resources as a foundation.

Popular resources usually don’t carry enough details for maximum success on coursework exams. But where they excel is putting topics in an organized fashion that is easy to learn and retain. Establishing that framework before going into a course lecture that is most likely going to be more disorganized can give your brain a head start on figuring out where certain details that your professor is emphasizing should go in the context of the entire topic. As with all these tips, it takes time and effort to review resources before each lecture covering a given topic, but it will almost always be worth it. Block out an extra hour each day before lecture to watch videos, or dedicate Sunday evenings to review a resources for the upcoming week. Once you’ve learned from your Step 1 resources and lectures…


3. Use flashcards with spaced repetition early and often.

Nothing sucks more than getting a question or seeing a topic and knowing you learned it earlier, but being unable to recall an important piece of information. Spaced repetition algorithms in each of the popular flashcard programs are the solution. Not only will they help drill home those nitty gritty details from your lectures, they will allow you retain all the information you acquire over your preclinical studies and help you keep it at your finger tips for your dedicated study period. Keep in mind the key words: spaced, repetition. In other words, this will be most effective if you continually do your review cards. But what if I don’t have time to add in extra review cards every day? You do! Shopping for groceries? Do cards in the checkout line! Pumping gas? Do cards while you wait! Boring family dinner? Excuse yourself to the bathroom and do cards! (Just kidding… Kind of…) It takes some squeezing to get through all the review cards everyday, but your future self will thank you when they don’t need to waste time re-learning all the distinguishing details about gram-positive cocci during your future dedicated study period. As you continually review…

4. Practice applying what you learn.

All this learning for courses and exams won’t do you any good if you know it, but can’t answer a test question when asked. The solution: do practice questions. While you can learn strategies and best practices for approach Step 1 questions, there are no true short cuts. You must do questions. Do hundreds or even thousands of questions. As many as you can. And the earlier you start, the more you’ll be able to do. As you are learning topics in school, pull up some questions in a UWorld or Kaplan QBank from that subject to see how it is tested. It will not only give you a step up on Step 1, but it will help you understand of alternative ways to see the material being presented in your coursework lectures.

5. Don’t completely disregard your lectures.

While it may seem obvious, it’s worth noting that succeeding in your coursework should be your first priority. No one cares what you got on Step 1 if you aren’t able to graduate from medical school. As difficult as it may be to subject yourself to professors who appear to have prepared for their lecture by just scanning polaroids of every page of a textbook from 1910, it is important to make sure you are getting the necessary information for your course exams. Depending on your program, you may need to devote additional study time if courses are graded, where as if you are familiar with the mantra “P=MD”, you likely can afford to glean the minimal amount of information from lectures in order to pass each test.


Preparing for Step 1 alongside your courses can be an energizing (or synergizing) experience that will lift both your coursework grades as well as your Step 1 score. It takes time and effort to efficiently establish the best strategy, but it is worth the extra energy now to save yourself some anxiety and stress during your final preparations to take the boards.