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You will find TONS of advice about Step 1! It is a big exam, but after all it’s only an exam. You prepare for it like you prepare for anything else that’s important--carefully. As you find information online and through friends about how people studied, just be mindful that there are many ways to study for this test and you’ll find the way that works best for you.
Step 1 is largely review, but not totally. There will be new topics that you will essentially teach to yourself. No one medical curriculum directly teaches every topic found on Step 1, but as long as you have mastered the main concepts, filling in the gaps during Step 1 study will not be too daunting.
The best preparation for Step 1 is learning the Phase I block content very well, meaning that you understand and can apply the main concepts. Your Phase I academic performance is a good indicator of how you’re likely to do on Step 1, but only an indicator. The intensity, organization, and persistence of your Step 1 study will significantly affect your exam performance.
Appreciate this time you have to integrate the main concepts of basic and clinical science in a way that might not have been possible during Phase I. Plan ahead for this independent study time without the distractions of course work. Pay attention to your personal well being during this study time as well, eating healthfully and continuing to exercise. Socialize at least once a week, and use “down time” to let the information “percolate” and “process.”
What’s your Step 1 score goal? Set a goal for yourself that is challenging but realistic so that you can use your score goal as motivation to organize your study and keep up your momentum throughout the study time. The passing score for Step 1 is 188, the national mean is ~ 222, and our school mean is close to the national. Competitive residencies will be impressed by scores above the national mean. But whatever score you earn it does not necessarily limit your career choices; it may simply require a brief explanation at residency interviews.
What’s your experience with test taking -- in general, and during Phase I? Do you experience a lot of anxiety around testing? Part of preparing to take Step 1 is reconciling your differences with taking tests. There is quite a bit you can do to alleviate undue stress during study time and when taking the test. You may find mindfulness relaxation exercises helpful (there are tons of good guided meditations on YouTube). Consider meeting with Dr. Franchini early in the study process to openly address these concerns. This is a very common issue that most medical students are able to overcome with practice.
Creating your study schedule takes time, so start during fall semester so that you’re ready to begin studying after the Infectious Disease block. You’ll have six weeks to study from the end of the ID block to the exam deadline date.
Using a review book such as First Aid for Step 1 (or the exam content list found on usmle.org), make a list of topics that you will concentrate on under the major subject headings. The specific topics depend on what you decide to spend time on during your Step 1 study, based on what’s considered high yield and on your own strengths and weaknesses. On your schedule, devote 1-4 days per major subject area (immunology, behavioral science, embryology, renal, heme/lymph, etc.), then break down the major areas into those smaller topics on which you decided to concentrate your review. This topics list is the outline for creating your daily schedule, and can be expected to adjust as you study, complete practice questions, and find new areas to review.
Monday-Tuesday-Wednesday-Thursday-Friday
8:00-10:00 am—Start with 1-2 sections of QBank questions on a specific topic, (46/one section), and increase the number of questions steadily during study period as you decrease the amount of time spent in content review.
10:00-12:00--Read through the QBank question explanations and create a “learning to do list” based on any information that is “new” or “need to know.” May want to keep a separate “vocabulary list” to track words & definitions as you come across words where you don’t readily know the specific definition.
12:00-1:00 - Lunch
1:00-5:00 pm--Study the topic in more detail using your newly created “learning list,” referencing review books and other resources to answer specific questions. Create brief drawings or flow charts to illustrate concepts. Refer to charts and other distilled information. If you find some topics need more time, just take the time needed to understand, and move on with your schedule.
5:00-7:00 pm--Dinner/Exercise
7:00-9:00 pm--Review important concepts from the day’s study, review broad “cross cutting” topics related to the specific topic of the day, for example pathology, pharmacology, physiology, etc.
9:00-9:30ish pm--Review the day’s work and adjust plan for next day if needed. You’ll likely find that certain topics took longer or shorter than planned to review, so your schedule changes a bit day to day.
Morning (9:00-noonish)—Construct a QBank quiz of 4 sections, 2-3 sections from material that you worked on during the week to solidify your knowledge and see where any remaining gaps are, and 1-2 section(s) fully random to review content you’ve already studied and preview content to see where your gaps are in subjects coming up. Study the answer explanations all afternoon, and add to your “learning to do list” as needed.
The recommendation is to do questions first then study content because if you study the content first, you’re tapping into recall knowledge not deep understanding from long term memory. When doing questions first, you probably won’t get the scores you’d like right away but you will get good information on what specifically you need to focus your study on. This is an efficient way to get through the material. Of course, if you decide to study first and do questions afterwards, you will still gain good information about what you recall from the day’s study.
In any case, it’s the combination of content study and practice questions (along with a thorough reading through the answer explanations) that gives you the best review.
Using both the Kaplan and USMLE World QBanks should give you enough questions to adequately cover all your content review. The best use of questions is for self-assessment, drill, and identifying exactly what it is you still don’t understand about a concept. Question explanations help to identify nuances within the answer choices which can help you tease out the specific details that make the difference between an almost-correct and actually-correct response. You may want to choose one QBank for study during the blocks and save the other one for Step 1 study.
Since the National Board of Medical Examiners (NBME) sponsors and coordinates the Step 1 exam, practicing with their own store of questions should prove beneficial. When used in conjunction with your content review and Qbank questions, the NBME practice exams offer a third point of reference to guide your studying and to assess your readiness to take Step 1. The exams are ordered individually on the nbme.org website, and along with a resulting score you receive an outline of your subject by subject performance. An “expanded” version can also be purchased where you can see the actual questions you missed, along with the answer you chose. Cost for the basic exam and report is $50, and $60 for the expanded version. You should plan to take an NBME exam at least every two weeks during your study time. Don’t wait until all your content review is done to take an NBME, use the results to guide and focus your study. Scores will inevitably increase as you get through all the material. Taking practice exams and doing lots of practice questions is also great for overcoming any test anxiety.
Check with an OARS Learning Specialist with any questions about a Step 1 study plan, or any aspects of your study, 925-4441 or email.
Office of Academic Resources & Support
MSC08 4710
1 University of New Mexico
Albuquerque, NM 87131
Basic Medical Sciences Bldg., Room B80
T: (505) 925-4441
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