How I scored 272

USMLE Step 1 Experience

272
100th Percentile

Introduction


I did not study for Step 1 until the beginning of 2nd year of med school, which is always a point of controversy amongst students, but as you can see it worked out ok. I approached Step 1 with aggressive learning of First Aid throughout the year (had to use the 2013 edition for a bit but then transitioned to 2014 when it came out). My goal was to not have anything unfamiliar to me in that book by the time I got to my dedicated study period. I think this was the single most important decision that I made. If anything wasn’t covered in lecture but in FA, I always did enough background reading (usually on Wikipedia) to understand the concept. That being said, here’s how I tackled the year from a resource by resource perspective.

USMLE Step 1 Study Plan


Qbanks

I’m a firm believer that UWorld should be saved for the dedicated study period. It’s such a rich resource that using it any earlier is a complete waste on your under-educated past self. However, I’m also the type of person that thrives on learning from questions, so I knew I wanted to get through the other Qbanks as the year went by. I started with Kaplan. This was in my opinion the most difficult one. Not because the questions were thought provoking like UWorld, but because the content can oftentimes be obscure or, in the words of the deity Hussain Sattar, “low yield.” Still, I finished Kaplan by February of 2014, and it helped me develop my strategy of test taking. Next was USMLErx. I used this after I finished Kaplan because I wanted a solid foundation in FA before I used the corresponding questions. A lot of people speak badly about this one, but I love questions, so I relished in the opportunity to continue testing my knowledge and further developed my question taking strategy (more on that in a little bit). I finished USMLErx in just before the start of my dedicated study period. Then came UWorld. UWorld is renowned as the gold standard of Qbanks for a reason. The complex questions and comprehensive explanations leave little to be desired. I would do all of the question sets I would have planned for the day, then review them. Any question I got wrong, I added to a powerpoint of wrong or borderline questions for that day, which I would then review when I would eat lunch every day. This helped me seal any gaps I had in my knowledge base going forward. How did I make powerpoints, you might ask? It’s against the terms of use for UWorld to screenshot, so I definitely didn’t do this. But let’s say one wanted to, one could run a Windows virtual machine, say Parallels for Mac, and use the option to isolate the virtual machine from your Mac. This way, Windows doesn’t even know it’s being run on a Mac. So if one were to use Mac shortcuts (like Command+Shift+Control+4) to copy part of the screen to your clipboard for pasting into a powerpoint running on the Mac, then Windows would be none the wiser. But I did not do this, as it’s against the rules. So I just, uh, typed everything out. Yeah, that’s what I did. Anyways, as far as question taking strategy, I always glanced at the answer choices and read the question before I read the stem. This way I could properly orient my mind for important details before mindlessly diving into each question. Why pay attention to the background info of a Psych question when you just need the time frame to distinguish the diagnosis?

First Aid 2014

Make it a priority from day 1 to know that book backwards and forwards. I would follow along with class lecture material, and like I said earlier, if there was something in FA not in lecture, I would read up about it. I want to make a quick note here and say I rarely annotated FA. Unless there was a concept or word I didn’t understand and wanted a quick reference, I left the book as is. It’s pointless to clutter the book with info that’s not important, because what’s in the book already is what’s important.

Pathoma

I think Pathoma is a hugely important supplement to lecture during the year. Nobody explains concepts and distills them down to the key facts like Dr. Sattar. And don’t pirate it. It’s such a valuable resource that I don’t think he charges enough. Plus he updates content so don’t risk missing out on the latest. I would just watch the corresponding video for the lecture material about once a week, and I rewatched all of the videos during my dedicated study period.

NBME Practice Tests

I took every NBME exam. It’s expensive, but it’s a great way to track progress and see where your weaknesses are. Also, my final score was right within the range of my test scores, so I’m a big believer in their predictive value.

Khan’s Cases

Not a terribly valuable resource. I don’t think it helped me get any extra questions on the test, but my test also had a lot of random ethics and behavioral science questions so YMMV.

USMLE Step 1 Mock Study Schedule


I had 5 weeks to study, and my goal was to get through UWorld x2, FA x2, and Pathoma x1 watching and another x1 reading.

06:30-07:00 – Wake up, get coffee, prepare for the day

07:00-11:00 – do 3-3.5 UWorld question sets followed by review and powerpoint creation

11:00-13:00 – work out, shower, eat, Skype with my SO, review old powerpoints

13:00-17:00 – review 1 full FA chapter while making a powerpoint for difficult to remember facts or concepts

17:00-22:00 – make dinner and eat while watching 1 Pathoma video; review old chapters if I had time

22:00-06:30 – SLEEP

Every so often I would sprinkle in an NBME in the morning instead of UWorld, which I would move to the evening in place of Pathoma.

Conclusion


I’m not guaranteeing you greater than 270, but I can say that this method will have you ready for whatever Step 1 will throw at you.

Preparation Time

  • Second year of medical school – 1 year

Books Used

  • First Aid for the USMLE Step 1 2014
  • Pathoma
  • Khan’s Cases: Medical Ethics

Question Banks Used

  • UWorld
  • Kaplan
  • USMLE-Rx

Audio Lectures Used

  • Goljan for Pathology

NBMEs Used

  • Every single one

*This post has been used with permission.