USMLE Step 1 score: 257

Preparation Time: 6 months

Background: My name is Mohammad, I’m currently a 6th year medical student. I
took USMLE Step 1 June of last year during my 5th year. I’ve been contemplating
taking step 1 since 1st year of university and was planning to take it by the end of
3rd year. However, I never had enough knowledge or guide back then to be able to
make a final decision and take the exam. What also made me reluctant about taking
it this early is that some doctors advised me to wait for clinical years to cover some
clinical science before I take it; as there’s an overlap in step 1 between basic and
clinical sciences.
Resources used:
1- Uworld: this was my main source and my cornerstone of knowledge for the
USMLE Step 1. I started solving 20 Questions daily and picked up the pace slowly
over time solving one block daily. Some days I wasn’t able to finish a block due to
clinical rotations but I would usually compensate on weekends.
2- BnB: I used this concurrently with Uworld (I would solve Cardiology from uworld
and view BnB videos for cardiology). I watched the videos at 1.5 speed and didn’t
read his slides.
3- FA: I did NOT use first aid at all during my prep for the USMLE Step 1. For me it
was boring and I would lose my concentration 5 minutes after reading it. FA is NOT
a teaching book and it requires you having good background of physiology and
mechanisms of diseases. I was skeptical about my approach of abandoning it
because everyone said it was a must but it worked out in the end.
4- Ethics: Communication and ethics questions are being emphasized in Step 1 and
Step 2 exams. I had a hard time understanding and solving them the first round,
but it became better the more I practiced them. I tried 100 ethics cases by Conrad
but didn’t find it very helpful as it didn’t make me solve any better. BnB wasn’t
helpful either. I found that resolving them from uworld for two or three times to
be the most helpful. I got 4 to 5 Qs on ethics and communication skills in each block.
5- Pharmacology: I did Kaplan 2010 Videos by Dr. Raymond. They’re golden I highly
recommend them. They are old so you will need to supplement them with a source
that covers the new drugs that came out since 2010. You can use FA/Uworld/BnB
for that.
6- Immunology: I did BnB and Uworld and they were sufficient.
7- Biochemistry: I tried Dr. Raymond’s Becker videos which are really good but are
really long. He approaches biochemistry in a very fun way. If you have time, I
recommend them. You can also try Dr. Turcot biochemistry 2014/2010 a lot of
people recommend them and they are shorter than becker’s videos.
Assessments
UWSA 1: 271 5 weeks before exam
UWSA 2: 269 1 week before the exam (I was really happy and confident at this
point)
Free 120: 90% days before the exam
NBMEs: Months before exam I was getting 20-25 mistakes at the end of my prep I
was getting 8-15 mistakes.
The real deal: The exam is doable but tricky. You will find questions you never saw
before and you will have to guess and exclude smartly; that’s totally normal. Every
block I had 4-5 questions that I had no clue about. In my first block, I ended up
flagging more than half of it because I was anxious – I drank too much caffeine the
day of the exam.
Advice:
1- This applies for any step. While solving Uworld ask yourself why this choice is
right and why the other choices are wrong before you read the explanations. It will
help you formulate differentials, exclude diagnoses, forces you to analyze and
deduce, and will get you to the right answers. Don’t rush. Learn to detect what's
important and what's not in the vignettes.
2- Always Ask yourself what does the Q want you to know or understand. Every
Question in Uworld and the real exam is written to prove and teach a point. Ask
yourself: what does this question want me to learn? This will help you a lot in
answering questions and in understanding how the test writers think, thus, you will
be able to analyze and answer better.
3- There’s no right way to study or solve. Find the way that is sustainable for you,
gets you the highest marks, doesn’t lead to burn out, and most importantly is
enjoyable. If I had forced myself to do first aid, I would have been miserable and
would most likely have procrastinated the exam further; which is bad.
4- Study for the sake of knowing and learn to love what you’re studying while doing
it. I hated immunology, biochemistry, and embryology in med school but I had to
learn to love them while preparing for step 1. That helped me a lot in understanding
these dreadful subjects and acing them. Find sources that are educative and
interesting at the same time. The problem is not in the topics themselves, it’s in the
way we study them and the way they were taught to us.
5- Fix your sleeping routine at least 1 week before the exam and don't change your
other habits during that period. I took a pre-workout -contains a lot of caffeine-
before the exam and I could feel my heart pounding throughout the 8 hours of the
exam.
6- Don’t let the pass/fail change the way you study for Step 1. Yes, USMLE Step 1
isn’t the most important thing in the world and it’s just another exam and there’s
a chance that no one will ever see your mark, not you or me or the program
directors. However, this is the mentality of the defeated. If you settle for less than
excellence once, it will become a habit.
7- Take Step 1 as early as possible especially now that it’s pass/fail. This way you
can apply for US Electives and research opportunities. You will be able to get letters
of recommendations from US doctors this way, which will increase your chances of
matching overall.
8- Lastly and most importantly, learn to love the process not the goal. it’s a blessing
to be able to learn all this and absorb all the treasures of science. None of it will go
to waste, whether you end up a physician or a scientist or an academic, it will be of
use one way or another. We thrive through science and science thrives through us.