Disclaimer: I am not writing this post to tell you how to study. Everyone is different and resources have varying effects on different people for each style of learning. Do what works for you. I also feel like I could have done better but I’m logging everything I did to be able to reflect and re-evaluate myself for Step 2. If you gain any insight from this, great, if not, no problem. I just wanted to remember what I did and how I can do better next time.

For reference, Nov 28, 2015 was the date of the SGU NBME that I used as a baseline. All other numbers are relative to that score. I decided not to disclose actual values but instead the deltas of my original score because I don’t think exact numbers will help give any insight into how you should study. The improvements over time relative to your starting point should be all that matters.

Study window: Dec 20, 2015 – Mar 12, 2016 (~3months / 12 weeks)

Resources used (# of times used/complete pass through)

• Review Courses
  • None
• Question Banks
  • UWorld Qbank (2 + incorrects)
  • Kaplan Qbank (1) – 1 month subscription
• Books
  • First Aid 2015 (2) *Pharm chapters (4), Rapid Review (5)
  • medEssentials for the USMLE Step 1 (1)
• Videos
  • Kaplan *Only biochem and anatomy
• Practice Exams (1)
  • Kaplan Diagnostic Exam
  • UWorld Self Assessment 1 & 2
  • NBME 11, 13, 15, 16, 17, 18
• Additional resources used before dedicated study period / alongside coursework
  • DIT (2) *Path and Pathophys
  • First Aid 2014 (1) *Pathology sections (2)
  • First Aid 2015 (2) *BSFCR
  • Pathoma (4) *Path and minimally for Pathophys

In Grenada, I made very little effort to directly study for Step 1 in the sense that coursework, exams, always had a priority. I did relevant pathology UW questions during Pathology but nothing more than that. I used First Aid to study for BSFCR quizzes and to review for pathophys during term 5. I went through DIT videos twice once before each week’s BSFCR quiz and once before the midterm/final. I had began to do UW questions for path/pathophys which was a good majority but I probably covered only 10% of all of UW by the time basic sciences was over.

When I made it home from Grenada, I averaged about 3-4 blocks a day to finish my first round of UW by New Year’s 1/1. After doing an NBME after my first round, I did not see the progress I was hoping so I decided to move away from UW and focus on content instead of questions.

I purchased a 1 month subscription of Kaplan’s Qbank which included a diagnostic and 2 simulated exams. I completed the diagnostic and the questions within the next 4 weeks but opted not to do the sim exams. I chose to go with Kaplan because I intended on making multiple passes of UW and I didn’t want questions to look familiar doing them back to back in a short window of time. I also wanted to see if Kaplan would ask things differently, which they did, and they covered different things and emphasized different things than UW. I used Kaplan alongside their MedEssentials book and I recommend using those two together. During this time, I did not use First Aid as much as I should have, if at all, but MedEssentials is the Kaplan version of FA and parts of it are definitely better while parts of it are not. I think using a combination of FA and MedEssentials throughout the study period helped a lot. A summary of a day during this month: 4-5 hours of questions, 4-5 hours of review and logging incorrect notes, 2 hours of purely content/MedEssentials.

As soon as I finished Kaplan, I reset my UW and started again. My averages were about 10-15% higher than they were during my first pass. I finished the second pass in just under 20 days at a rate of 3-4 a day (timed, random, 44). I found using tutor and untimed made me work through questions slower overall (lesson I learned from the first pass). Also, going through questions “twice”, once as you do it, and once as you review, forced me to go through the thought process twice. When I did tutor, I would sometimes get a string of incorrects just because mentally I’d still be beating myself up from getting the last one wrong and so on. Also, timing was never an issue for me but it didn’t hurt to keep myself on a good pace so there would be no surprises. On review of UW, I would purely read the answer first, then take notes on the incorrect. My strategy for note taking changed a lot since I started. Initially I made Anki Flashcards for each question/concept, then slowly moved away to just cards for the incorrect and then moving even further to just a list of facts. I think the most effective method was to have a word doc or notebook with a list of 1 line facts that I did not know and needed to know to answer that particular question right. I found that the other 4 answer choices were in fact not necessarily ever tested and if they did want to test it, it would have it’s own question where that question was right, in which case, I would make another line in my notebook if I did not know it, otherwise, I didn’t bother. Granted, this was my second pass through UW so I was focused on learning from my wrongs instead of trying to get questions right. During a first pass, if you went through and learned all the answer choices, you might not get the second version of the question wrong which is also a good thing but I suppose that comes to personal strategies. After finishing UW for the second time, I then focused on purely reading First Aid again since I didn’t really ever sit down to just do First Aid since I did DIT term 5. I was about 1 month out and for that first week I did a mix of First Aid and one day of UW assessments 1 & 2 back to back. I wanted to simulate a full exam and also my first score was lower than I wanted so I used the second one to boost my confidence before I lost it all over night dwelling of a perceived failure.

Throughout the next few weeks, I read through all of First Aid again, repeatedly went through the Rapid Review section with friends just quizzing each other, and then mixed in 1-2 blocks of incorrect UW questions on tutor mode and making an abbreviated notebook of those incorrects. I would attempt to review that book of [my incorrect] correct facts every morning, blocks until lunch, First Aid after lunch and then rapid review at night. I thought the process was more complex than that but now that I’m writing it out, that’s pretty much all I did. FA and UW, no additional resources during the last month.

On step day, I got there early, ended up starting a few minutes early, took a break every 2 blocks and somehow ended up with more break time than I started with after the entire day was over. The time you don’t use during the tutorial goes into the actual break time and if you finish early that helps too although I never finished with more than 10 minutes to spare (I have always tried to pace myself averaging 1 minute / question to be safe)

Looking back, some things I would do differently: Use First Aid more heavily initially, did Kaplan before UW maybe during term 5 instead (I found using Kaplan was more useful to learn from rather than UW which is more of an assessment. The question styles are the same but the explanations in Kaplan are simpler to read but help me with the concepts rather than the connections and also cite FA nicely). I also would have liked to have had more time to make Anki flash cards the way I did initially and then time to actually use them but it was super time consuming so I’m not sure if I would do it if I had the chance. They definitely helped but I feel like my time might be just as well spent reading entire sections of FA. Other than that, I wish I scheduled my exam for sooner/earlier by a week. I definitely became fatigued just from time spent 100% studying and mentally peaked a few days before my real exam. That being said, I still passed and still made significant improvements from my baseline. I will definitely make sure Step 2 goes differently but I know that I was capable of doing much better than I did even though it might have been good enough with regards to pass/fail.

I will likely add/edit this post when I remember more and if there are any comments/questions I will edit as necessary