My resource recommendations for USMLE Step 1

So, after reading my very messy, not to be imitated Step 1 story, you may not want my advice on actual Step 1 studying, considering my struggles. That’s entirely fine, but I will remind you that after all my struggles, I did end up with a score high enough to not get cut off for any specialty (including the high profile ones, like derm and plastic surgery—all glory to God!). But for those who do, here is where I get into the actual nitty-gritty—the actual advice for studying. Hopefully this helps a couple of med students. Remember, if I made it with my vacillating motives, you sure can!

As I mentioned in my intro, there are a lot of resources for Step 1 studying, which is good because people have different styles of learning, but can also be overwhelming. In brief, I used UWorld (a question bank for Step 1 that had about 2800 step 1 practice questions the last time I saw it), the First Aid for Step 1 book, and Sketchy Micro. I also read the first three chapters of the Pathoma pathology book and listened to exactly 1 Pathoma lecture. And I used about four Boards and Beyond lectures, mostly for cardiovascular physiology.

It doesn’t matter how many resources you use as much as HOW you use them. As I said in my last post, I started doing UWorld questions five months before I took Step 1, but I was doing questions just to do questions; I didn’t take the time to review the questions i’d gotten incorrect, and for a long time I was only using UWorld without supplementing with First Aid or any other comprehensive resource. Because of this, my scores on the UWorld practice blocks stayed at a low percentage for a very, very long time. When I started reading my notes and First Aid along with doing questions, my UWorld scores, practice test scores, and real test score went WAY UP.

UWorld

A lot of people ask how many times you have to do UWorld in order to do well on Step 1. My answer to that is to do all 2800 questions at least once, along with reading and reviewing your incorrect answers as frequently as possible (read: taking notes on every single question you get incorrect, and reviewing those notes every day!). My school would have people contact the academic counselor if they had not done all of UWorld at least once before their planned test day. If you’ve done all 2800 questions of UWorld once, I STRONGLY RECOMMEND going back and doing all of your incorrects until you get them all correct. Aside from letting you review your incorrects one more time, it’ll also give you confidence to see yourself getting questions right that you’ve gotten wrong before, and confidence is KEY on Step 1. (Because you’ve seen the questions before, revisiting your incorrects takes much less time than doing UWorld for the first time—it shouldn’t take more than a couple of days. I’m not kidding!) After doing your incorrects, I again STRONGLY RECOMMEND that you go through as many of the UWorld questions, correct and incorrect, as possible. (Again, this should take less time and feel much easier than your first time going through UWorld.) This will help you review questions that you got correct off a guess (med students, YOU KNOW) and also give you even more confidence. I personally (with my mom’s moral support—thanks mommy!) went through a total of about 2200 questions (incorrects + corrects) after doing UWorld for the first time, for a total of 1 3/4 “passes” through UWorld. So, my strong, USDA grade A recommendation is to do all 2800 questions in UWorld twice (or at least as close to twice as possible) with daily note review. But at the very least, you should do all of UWorld once with daily notes review.

Also a note: to rent UWorld for 1 year costs $380. The cost sucks, but most med students will verify that it really is the top question bank out there, with explanations unrivaled by any other question bank.

Because of how many questions UWorld has, a lot of people start doing questions before the dedicated period that most schools give, often starting in January of that year, like I did. Looking back, I would have started UWorld then, but I would have done less questions a day—I was trying to do 40 questions a day, and that made NO SENSE with the amount of work I had to do for my other blocks. I would have started by maybe doing 10-20 questions a day, and then have ramped it up to 40 questions day starting in March. My school goes by systems blocks (studying the heart for six weeks, then the lungs for six weeks, etc.), so if I had been really smart (sigh), I would have either started my first pass of UWorld early second year and have done relevant questions along with each block.

First Aid for the USMLE Step 1, 2019 Edition

First Aid was pivotal for me. I started actually reading First Aid pretty late in the game, and all of a sudden everything made sense. Learning from UWorld alone felt disjointed for me because I was learning in random tidbits from each question and not connecting everything together; First Aid put everything, by system, in a book, so that I could read how everything goes together and connect everything in my mind. Many people will tell you to follow along with First Aid throughout your first and second years; I’m sure I should have done this, but I didn’t. I can tell you this; if you read about 55-60 pages of First Aid a day, you’ll be done with the book in 2 weeks. I highly recommend reading First Aid from front to back once. Some people will say to read First Aid twice so that you can absorb the information; I would say absorb the information on your first run through and save yourself time and stress! (You could apply the same philosophy to UWorld, but I still recommend doing UWorld twice because of the confidence factor.) As another plus factor, it’s probably the cheapest resource on this list, at about $41.68 from Barnes and Noble for the 2020 edition (just typing 2020 feels weird!).

SketchyMicro

SketchyMicro was one of the few resources that I used before Step 1 study time, and it was one of my favorite resources, though not everyone likes it. For those who don’t know, SketchyMicro is a video-based resource that essentially uses drawings with visual cues to help you remember various facts about bacteria. It’s hard to explain, but for me IT WORKED, and it made microbio so much easier. I’ll link a video here, on Vibrio cholerae, so that you can see how it works. SketchyMicro has been so successful that they’ve expanded into SketchyPharm (for pharmacology), SketchyPath (for pathology) and SketchyIM (for internal medicine), but SketchyMicro is the original and the best, since the videos are short and the drawings don’t get too complicated. I also used a bit of SketchyPharm, but the videos are longer and the drawings are way more complex for that one.

Officially, SketchyMicro costs $99.99 for six months ($16/month) and $159.99 ($13/month) for a year on SketchyMedical’s website.

Pathoma and Boards and Beyond

Many of my classmates swore by these resources first and second year. I only used them right before the exam. I bought the Pathoma book (you can get it on eBay) and read the first three chapters, as I was told that those are the most useful chapters on the test. The book and resources are very helpful for pathology if you struggle with that; I personally thought my school taught pathology really well, which is why I barely used it. Boards and Beyond helped me review concepts that I had forgotten and that I needed to understand, such as cardiovascular physiology. If I had to go back and do second year another time (God forbid), I would have used Boards and Beyond for my cardiovascular and renal blocks, as the physiology in those blocks was very hard to understand.

Practice tests

They feel awful, but you’ve got to do at least a couple of them. The aforementioned UWorld Step 1 question bank comes with two practice tests, and the NBME (the people who administer Step 1) have 6 practice tests for $60 apiece (sometimes you can get vouchers from your school to shave off the cost). The NBME practice tests are VERY HARD; many of the questions will stump you even if you’ve been studying really hard. But on the bright side, if you do okay on one of them, that probably means you’re okay for the exam. To give you an idea of how hard the NBME practice tests are, my highest NBME score was 20 points lower than my actual test score; I’m not kidding. (More conservative estimates would put you at a 10-15 point difference.) The UWorld practice tests are easier than the NBMEs, but they’re still good practice.

In both cases, the practice tests are only about half as long as the actual test (4 sections of 50 questions each, while the actual test is 7 sections of 40 questions each). If you do them like an actual exam (do every section straight without a break, don’t take long breaks between sections, sit somewhere abnormally quiet, etc.), it’ll help prepare you to sit for the real one. If you want to be a study pro (and be mean to yourself), you can do a full practice test by doing a UWorld practice test and then three 40-question sections of UWorld afterward.

As a guideline, my school told people to delay their test date and study more if they did not get at least a score of 205 on an NBME practice test or a score of 220 on a UWorld practice test before their scheduled test day. The implication is that if you get at least those scores on a practice test, you are almost guaranteed to pass the actual test. (And of course, the higher the actual score that you’re aiming for, the higher your bar should be for the practice tests.)

Resources for setting up a timetable

If you have money or are willing to use loan money, Cram Fighter is a really good, not-too-expensive resource that can help set up a timetable for you to balance your various study resources during your dedicated study period. It costs $29 a month and $79 for 3 months. A less costly (read: free), similar site that I used in college is Get Revising, which is a UK-based resource that does the same thing—the only thing is that the United States Medical Licensing Exam is not a specific exam in its British database. That just means that you have to do the work to enter the resources you’re using and the time it takes for you to do them.

You can also look on YouTube to see how other medical students have done their timetables. Here’s a video that I found helpful, by Ambitious Abe on YouTube (he also did very well, scoring a 250). He actually has his own Step 1 study guide as well, just on YouTube, so hopefully you find him and me helpful!

Whew! Your girl has a LOT to say about Step 1. Look for part 3, coming soon to a blog near you.