Hi, Im a fourth-year student at the University of Queensland in Australia.

I sat the USMLE

Step on the !th of "e#em$er, %&%, and I 'ould li(e to share my e)perien#e 'ith those 'hom
may find it helpful.
I had not planned on nor had I ever #onsidered sittin* the USMLE until I had almost finished
MS%, so my fo#us $e#ame that of ta(in* the e)am at the end of my third-year +first ,h" year-. I
thou*ht the prep 'ould $e relatively simple. It 'asnt. .he Australian #urri#ulum pla#es very
little emphasis on the $asi# s#ien#es, and I had to learn the vast ma/ority of the material from
s#rat#h. .his is mostly 'ith respe#t to em$ryolo*y, mi#ro$iolo*y, immunolo*y and
pharma#olo*y, as 'ell as $iostatisti#s. 0io#hemistry 'as also not #overed at UQ, $ut fortunately
my under*rad ma/or 'as in the su$/e#t, so it never $e#ame an issue for me.
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1or the sa(e of #larity, the Australian a#ademi# year is the same as the #alendar year, so #lasses
run 2anuary-3ovem$er, not Au*ust-2une.
Pre-preparation phase:
"urin* my MS% +%&-, I spent the first semester +2an-May- readin* $i* 4o$$ins. .his is
pra#ti#ally all that I did. I spent pro$a$ly !-5 hours per day *oin* throu*h this $oo(. 6n#e
a*ain, this is $efore I had ever planned on sittin* the e)am, and truthfully, I 'ouldnt re#ommend
*oin* throu*h this $oo( either. It #ontains a ton of information and is un7uestiona$ly one of the
*old standard resour#es out there for path, $ut its not presented in a 'ay that is even remotely
#on#ise enou*h for effe#tive USMLE prep. .hat is let alone the fa#t that the ma/ority of the te)t
is lo'-yield. Use this tome as a mere referen#e.
In 2une of my MS%, I had #ome in #onta#t 'ith a student at my s#hool 'hom had played a
transformational role in my learnin*. He $e*an to mention some of the resour#es he had found
to $e helpful. I pur#hased 04S ,atholo*y, and after havin* read a #hapter of it, immediately
/ettisoned the 4o$$ins method. 04S ,ath is super 'ell-#onsolidated and presents the ma/or
ideas as hi*h-yield $ullet points. I found this or*ani8ation to $e $etter #atered to my learnin*-
style $e#ause I 'as a$le to simply memori8e the #hapters 'ith ala#rity as opposed to havin* to
filter throu*h mu#h of the lo'-yield info in 4o$$ins. ,er the same num$er of hours spent
studyin* thereafter, my effi#ien#y 'ith re*ard to learnin* hi*h-yield information had $een
improved si*nifi#antly.
"urin* semester-t'o, I 'ould revie' a #hapter in 04S ,atholo*y on the Sunday or Monday
before that #orrespondin* topi# 'as dis#ussed in ,0L on .uesday. .his 'ay, I entered the 'ee(
already havin* had a pretty *ood summary of the ma/or ideas as opposed to havin* merely seen
them for the first time in ,0L. .his helped me fa#ilitate the #lass dis#ussions. 6n 9ednesdays,
I 'ould #ontinue readin* 04S ,ath and memori8in* it the $est that I #ould. It too( me a very
lon* time to *o throu*h the #hapters $e#ause I *enerally made sure I #ould reprodu#e them $y
memory repeatedly $efore movin* on.
6n .hursdays, I had patholo*y pra# at the hospital, so I 'ould spend the pre#edin* -.: hours
in the spe#imen loun*e readin* "e/a4evie' USMLE Step. .his 'as a *reat top-up to 04S.
.his $oo( has a Q;A-type format. I 'ould *o throu*h the #orrespondin* topi# that 'e 'ere
#overin* that 'ee(, so I 'ould enter pra# already havin* read 04S and "e/a4evie'. .his on#e
a*ain helped me to parti#ipate. .he a#tive involvement served as positive-reinfor#ement, so this
04S-"e/a4evie' method durin* the early-mid-'ee( 'or(ed 7uite 'ell for me.
.he #at#h is that the patholo*ists le#turin* the pra#s almost al'ays developed their ,o'erpoints
dire#tly from 4o$$ins. So the fa#t that I 'as no lon*er perusin* $i* 4o$$ins 'as $enefi#ial
$e#ause instead of havin* to *o throu*h the te)t myself to e)tra#t the main ideas, I let the pra#
tutors do the dirty 'or( for me. In other 'ords, their ,o'erpoints essentially $e#ame my
4o$$ins summaries, there$y further o$viatin* the need for me to referen#e that te)t. So $y late-
.hursday, I had also <#overed= 4o$$ins.
I then spent 1ridays and Saturdays *oin* throu*h topi#-spe#ifi# 7uestions on University of Utah
9e$path and in 4o$$ins 4evie' of ,atholo*y. 9hi#hever 7uestions I had not mana*ed to
#omplete at the end of a *iven 'ee( I al'ays made sure to finish $efore SoM e)ams. .hese
7uestions, parti#ularly the 9e$path ones, in #om$ination 'ith my #han*e in resour#e-use,
improved my *rades dramati#ally. I even re#all a freneti# post-e)am de$ate people had had on
our SoM forum a$out an am$i*uous 7uestion, $ut I had seen an almost identi#al 7uestion on
9e$path 'hile studyin* /ust days earlier. I #annot advo#ate more the value of 9e$path. Use
this resour#e.
6n#e Saturday passed and Sunday arrived, I did not tou#h material from the previous 'ee(.
Sundays al'ays e7uated to *ettin* a /ump start on the ne)t 'ee(. If I had felt at any point that I
had needed to #ontinue loo(in* at stuff from the previous 'ee( > too late. Sundays 'ere stri#tly
for preparin* for the ne)t 'ee(. ,eriod. Stayin* one step ahead is e)tremely important durin*
MS%. Its never harmful to revie' previous 'ee(s material from time to time, $ut *oin* into
ea#h ne' 'ee( 'ith foundation 'ill not only positively reinfor#e your #omfort 'ith and
#ommand over MS% material, $ut it 'ill also *ive you the a$ility to $e a more helpful, influential
and impa#tful #ollea*ue.
"urin* the neuro 'ee(s of MS%, I had also *one throu*h H? 3euroanatomy SE@63" edition.
I emphasi8e that I used the se#ond edition $e#ause, several months later, I had #oin#identally
loo(ed at the :th edition that one of my friends had for #omparison, and I found that althou*h the
latter 'as mu#h more presenta$le and overall more informin*, it 'as also mu#h less #on#ise.
My impression 'as that the :th edition 'ould $e *reat for someone in MS 'ho 'ants to learn a
$roader foundation in neuro, $ut that the %nd edition 'as still $etter for USMLE prep. 4esour#es
may $e#ome more affa$le 'ith time, $ut that doesnt mean they al'ays $etter serve their
purpose.
9hen I approa#hed the end of MS%, I de#ided that it 'ouldnt $e un'ise to (eep my options
open for the future, so I $e*an preparin* for the USMLE.
Preparation phase:
In late-%&, althou*h I had several friends 'hom had $een preparin* for the USMLE durin*
MSA% and 'ere sittin* it in a fe' 'ee(s time, I 'as still yet to have seen 1irst Aid. I (ne' I
'as in no position to ta(e the e)am any time soon. I $e*an $y pur#hasin* the San/iv Mi#ro#ards
and Under*round @lini#al Bi*nettes > Anatomy. I 'ent throu*h $oth of these resour#es
hapha8ardly durin* "e#em$er %& and 2anuary %&%, $ut had finished $oth $y the end of
2anuary %&%. I also started listenin* to the Col/an audios. I only 'ent throu*h a$out t'o-thirds
of them $e#ause I 'as impatient and only found them to $e moderately helpful +I should ma(e
note, ho'ever, that this 'as only $e#ause my patholo*y 'as already pretty *ood $y the time I
finished MS%D had I started listenin* to Col/an a year earlier, I definitely 'ould have found him
to $e phenomenal. I hi*hly re#ommend the Col/an audios durin* MS%.-. In addition, I $ou*ht
the Lan*e pharm #ards. I only 'ent throu*h a$out %& or so of these at this point in time, then put
them aside.
Mid-2anuary %&%, my sister had pur#hased for me a <till you pass= su$s#ription to USMLE 4)
Q0an(. I did && 7uestions in tutor-mode and *ot 5E #orre#t. I noti#ed that alon*side the
e)planations there 'ere also ,rntS#r ima*es of pa*es from 1A, and that the vast ma/ority of the
7uestions I 'as *ettin* 'ron* had ans'ers strai*ht from the te)t. I reali8ed that I 'as $etter off
first readin* 1A and then ta#(lin* the Q0an( for reinfor#ement, as opposed to $lindly doin*
7uestions first. So I pur#hased 1A%&%. In retrospe#t, I $elieve I 'as pro$a$ly sittin* around a
F&-%&& had I sat the USMLE at this point. Althou*h 5:G is a$out the avera*e in 4) +'hi#h
means one #ould ar*ua$ly say a %%& 'as possi$le for me-, this fi*ure is left-shifted fi*ure
$e#ause most people 'ho utili8e 4) do so early, rather than late, in their prep +so this is an
avera*e amon* less prepared test-ta(ers-.
I spent three 'ee(s durin* 1e$ruary at H-% hrsAday readin* 1irst Aid #over-to-#over. .here 'as
su#h a lar*e volume of info that I s'ore I 'as for*ettin* most of it, $ut I #ontinued on. .he day
after I finished 1A +in late-1e$ruary-, I re#ommen#ed USMLE 4). I noti#ed immediately a
dramati# differen#e and 'as avera*in* around H:-F&G on $lo#(s, in #ontrast to the 5EG I had
mustered $efore havin* tou#hed 1A. I spent H-& hrsAday durin* Mar#h and April la$orin*
throu*h 4) at a mere !H 7uestionsAday in random, tutor-mode. I annotated everythin* I found
important into 1A. .his snail pa#e 'as due to the fa#t that I had not seen most of the material
$efore. 0ut on the other hand, I 'as inadvertently learnin* a lot.
0y the time I finished 4), I #ould tell that my *rasp of the material had #han*ed drasti#ally. I
$elieve at this point I 'as pro$a$ly sittin* around a hi*h-%I&, or /ust ni#(in* %!&, if I 'as lu#(y.
I spent the month of May *oin* throu*h 04S 0ehavioral S#ien#e at a #hapter per day. I read
ea#h one in the mornin* $efore startin* my <real= studyin*. .his method made the read very
mana*ea$le. I had started this $oo( $e#ause $ehavioral 'as my 'orst su$/e#t in 4), so I had had
to remediate someho'. "urin* the day-time, I 'ent throu*h 1A Q;A and Japlan Q0oo(. I did
not annotate my 1A from these resour#es, and I read only the e)planations from Japlan Q0oo(.
.his 'as mostly $e#ause 1A Q;A 'as very easy, $ut Japlan Q0oo( still assessed 7uite a fe'
details I had not en#ountered $efore. I then too( a solid ten days to'ard the end of the month as
a va#ation roadtrippin*A$a#(pa#(in* up to @airns and the Creat 0arrier 4eef for s#u$adivin*
+hi*hly re#ommend this if you ever tre( do'n under-. 0e#ause I had $een travelin* 'ith my
*ood friend, 'ho is also a med student, he happened to have had a #opy of Under*round @lini#al
Bi*nettes > 0ehavioral S#ien#e lyin* on the floor of his #ar. So durin* do'n-time, I $lasted
throu*h this $oo(.
I should also mention that for the first half of the year, 'henever I had *one any'here via pu$li#
transportation, I 'ould randomly read either 1irst Aid @ASES or Step SE@4E.S. I finished
@ASES $ut only read a$out one-tenth of SE@4E.S +see my revie's at the end of this post-.
2une and 2uly 'ere more tur$ulent and desultory study months $e#ause I 'as travellin* a lot and
had had family o$li*ations. I spent the first ten days or so of 2une initiatin* my se#ond #over-to-
#over pass of 1A. I then #urtailed this effort and loo(ed into Cunner .rainin* $e#ause some
people had raved a$out it. I did not li(e the flash#ard system +personal preferen#e, althou*h
some people love it-, so I instead /ust did their Q0an(. I 'ent throu*h it at around :&-%&&
7uestions per day, annotatin* into my 1A here and there, $ut not reli*iously. 0y the first 'ee( of
2uly, I had finished C. Q0an(. I then 'ent throu*h H? @ell ; Mole#ular 0io, and then
re#ommen#ed my se#ond #over-to-#over pass of 1A from 'here I had left off previously. I
finished 1A a*ain $y late-2uly. My se#ond pass of 1A too( a$out the same amount of time as
my first pass had. .he differen#e 'as that the se#ond pass in#luded the need to revie'
annotations, so I 'as pro$a$ly #overin* K%&G more te)t in the same amount of time. Even still,
it 'as 7uite a slo' pa#e. I also $lasted throu*h the Lan*e pharm #ards and 0renner #ards. In
2anuary, it had ta(en me several hours to *o throu*h /ust %&-%: #ards. Ho'ever no', I 'ent
throu*h all of the Lan*e L 0renner #ards in /ust t'o days. .he 0renner had some lo'er-yield
dru*s, so I 'rote the ones I hadnt heard of $efore on post-it notes and put them on my des(. I
'ould 9i(i a random dru* every other day or so. 0y the time I sat the e)am, I (ne' the dru*s in
1A L Lan*e #old L a handful of the lo'er-yield ones in the 0renner sta#(.
I then sat 30ME-I online late-2uly +they retired this e)am on 2uly I&th, %&%- and s#ored %:&. I
spent t'o days flippin* throu*h random 7uestions from the $ehavioral and pharm Japlan le#ture
notes and then started Japlan Q0an( the first day of Au*ust. I 'ent throu*h Japlan Q0an( at
5-H hrs A && 7uestions A day in random timed-mode. .he :&-7uestion dia*nosti# L %%&&
Q0an( L t'o full-len*th e)ams M KI&&& 7uestions. I *ot throu*h everythin* in /ust one month.
I annotated Japlan into my 1A in oran*e in(. So at this point, $lueA$la#( annotations 'ere
mostly USMLE 4) and C. Q0an(, and oran*e 'as Japlan.
.he first day of Septem$er I started U9orld. I thou*ht $e#ause I had $een a$le to *o throu*h
Japlan so 7ui#(ly that my U9orld pa#in* 'ould $e #ompara$le. 9ron*. I found U9orld to $e
in#redi$ly info-dense, and I pro*ressed at a similar speed as I had 'ith USMLE 4)N 5-H hrs A :&
7uestions A day. 9hereas 'ith 4) I had done one !H-7uestion $lo#( per day, sin#e U9orld only
allo'ed a ma)imum of !5 7uestions per $lo#(, I did t'o %:-7uestion $lo#(s per day. I 'ent
throu*h my first t'o $lo#(s of U9orld in tutor-mode to *et a##ustomed to the interfa#e, $ut then
did the rest of the Q0an( in random timed-mode. I finished U9orld $y mid-6#to$er and had
made all of my annotations into 1A in *reen in(.
I 'ent on to do all of the offline 30ME e)ams +, %, ! Oplease dont as( me for these $e#ause I
dont have themD if you 'ant them, ma(e a thread as(in* 'here to find them and someone 'ill
,M youP- and some other random 7uestion sour#es, su#h as Mi#ro#ards Q0an( +KE: 7uestions-
and U9orld $iostats ,"1 +KE: 7uestions-. I then sat 30ME-: online late-6#to$er and s#ored
%:E. I 'as surprised that I had done a si*nifi#ant amount of 'or( sin#e late-2uly and had only
in#reased seven points on the 30ME. I $e*an to reali8e that my pro*ress, if *raphed, li(ely
resem$led the H$-6% disso#iation #urve. I 'as a'are that preppin* $eyond this point 'asnt
ne#essarily *oin* to $uy me additional points as mu#h as it 'as /ust $uildin* my #onfiden#e and
#omfort in $ein* a$le to a#hieve a OIPminimumOAIP s#ore. In other 'ords, I (ne' puttin* in
additional months of study ultimately 'asnt *oin* to *uarantee me a super-hi*h s#ore as mu#h
as it 'as merely safe-*uardin* me from a lo' out#ome if the random allotment of 7uestions on
my real USMLE turned out to $e unfavora$le. I 'ould say on#e you reali8e youre enterin* your
plateau phase, youre $uildin* potential, rather than (ineti#, ener*y. It 'ill ma(e you sli*htly
du$ious as to your methods, $ut its #ompletely normal. ?ou /ust need to #ontinue pushin*
on'ard.
After I sat that 30ME in late-6#to$er, I 'ent throu*h the USMLE 4) for the se#ond time. I did
a$out :-5&& 7uestions $efore reali8in* that they 'ere far too easy #ompared to the ones in
U9orld. 9hile they 'ere *reat durin* my early prep, this late in the *ame, I (ne' it 'as $etter
to fo#us on other thin*s +ho'ever, if you are late in your prep and havent done 4), I 'ould still
re#ommend itD one pass 'as *ood, $ut not t'o. 4e*ardless as to ho' easy the 7uestions are,
there 'as still some stuff that sho'ed up on my real USMLE that I had only en#ountered
throu*h 4)s e)planations-.
So after those :-5&& 7uestions, I $e*an my third #over-to-#over pass of 1A. .his time, I had
needed to read not only the te)t itself, $ut also all of my annotations from the past half-year. I
had +'ith no e)a**eration- pro$a$ly dou$led the len*th of my 1A. I OIPstill OAIP'ent throu*h at
rou*hly the same pa#e as I had the first t'o passes. 0ut $e#ause the len*th of te)t had $een
au*mented #onsidera$ly, I 'as a#tually readin* pretty fast. In #ontrast to the first t'o passes,
ho'ever, for the third one, anythin* that 'as not already &&G en*rained in my memory I 'rote
do'n in a separate note$oo(. I filled up a$out half a small note$oo( 'ith my tiny hand'ritin*.