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Updated on July 5, 2011

You can get the score of your dreams

Studying for the USMLE Step 1 is one of the most daunting tasks a medical student must face. Your score on this exam often determines what residency you can realistically apply for and thus determines your career trajectory. Many students feel panicked and unprepared by their medical school curricula. However, with determination, perseverance, hard work and the tips below it is possible for any student to achieve a good score.

study secrets
study secrets

Set Aside Time

Most Schools give you a block of time to study for the USMLE. This time is usually more than sufficient. Try and save some of it for a little vacation before you start third year clinical rotations. Most student found the ideal study time was somewhere around 6 weeks. Longer studying time begins to wear you out and frustrate you. Do not schedule the exam the day before you start your medicine rotation. You will burn out and go crazy from worry. I know it seems overwhelming but you can do it! Usually in less time than you think.

USMLE Step 1
USMLE Step 1

Make a Plan

and stick to it

The most crucial part of studying happens before you even crack open a book. Having a well thought out plan will help you stay focused and on track. Ask senior students to share their plans with you, devote more time to your weaker areas and remember to schedule in time for practice. You can modify the plan as you cover material but do not let yourself get derailed. The plan is your best friend. Treat it as such.

Gather you Study Materials

Try and have your study materials laid out in an orderly fashion. If there is a senior student in your school that has a similar study style to yours you might ask them what materials they used. Often you can buy these books at a discount from students who taken the exam. Whatever you do, do NOT go back to the giant textbooks, handouts and stack of class notes that you have from the past two years of medical school. You will wear yourself out without learning any information that is useful for the USMLE. This process is about High Yield studying. Massive review books from kaplan are pretty low yield.

The first place most students go is "First Aid" or "Step-up". These books provide a great high yield overview of each topic. I do not know how they do it but I swear every question I was asked on the exam had an answer that could be found somewhere in First Aid. There are also several other books put out by the same company that have case studies or Q and A. These books are all very high quality.

Flashcards- these are great to carry around with you especially on the subway. They are great for topics that are huge on the exam but insufficiently covered by most medical schools like microbiology and pharmacology. Beware of cards that are textbooks in disguise. If the card is so covered in text you can barely see the white background, move on. It is a wast of your time.

High Yield and BRS series - These two series are great reviews although a bit lengthy. They can really help in your weak areas. My guess is you have some from previous coursework. Take out one for consultation. There is no need to read both or topics you are all ready solid in.

QBanks - Having a qbank is well worth it. Some people even get two. Most high scorers (including myself) that I have consulted feel that USMLE World is the best qbank. The material is thorough and the difficulty is representative of the real exam. Many people bought Kaplan, were frustrated by the non representative difficulty level and found it hard to study from. It truly was not representative of the real exam. USMLE RX and USMLE easy are good secondary qbanks.

Goljan- His "Rapid Review" pathology is one of the best path books out there. However it is a bit tough to read and lengthy. What he is really known for are the pirated audio files of his fabulous review course lectures. There are copies circulating around every medical school. But you did not hear that from me. Be wary - he makes some mistakes about topics that are not in his field of pathology. But overall, audio learners really liked these. Lots of people listened to them at the gym.

Review Courses - In contrast to the MCAT when it comes to the USMLE classroom review courses are really not the way to go. Most U.S. medical student would be wasting their money. They are usually designed for people who have failed the USMLE multiple times, have no idea how to format their own study time and need serious remediation.

There are thousands of books out there. Do not lose site of your goal while trying to select from amongst them. Pick a few and get down to studying.

nbme exam
nbme exam

Practice Makes Perfect

A key step to studying is getting your nose out of that review book and learning to apply your knowledge to questions. Remember that qbank you bought? Use it! This reinforces what you learned and sometimes teaches you something new. You should try and do as much of this practice as possible in the test format - timed and on a computer. If you are not used to pacing yourself you will not do well on the exam.

One of the best things I did was take the practice exam offered at the testing center. You register for this in the exact same way that you registered for the real exam. This lets you get familiar with the center (mine did not allow food in the building. I had to leave for lunch) and serves as a dry run before the real test. It is half the length of the actual exam. Note that the questions on the exam are the same as those released by the NBME in their FAQ about the exam. Do not look at them beforehand!

What Type of Student are You?

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Do not neglect you life or your family

you will regret it

Studying for the USMLE does not give you the right to become a hermit. Shaving and bathing is not optional. I do not care if you plan to never leave your room or the library. Looking like a yeti is not acceptable. Other people in your life should not be expected to pretend you don't exist or are away on some secret CIA mission for two months. Leave room in your schedule for you friends and family.

You should also leave room for yourself. Are you someone who goes to the gym everyday? Thinking about stopping that to use that hour as extra study time? Don't. Your body is used to that gym time and all the other habits you had (cooking your own meals, walking the dog). Suddenly loafing on a coach in your pajamas while eating frozen pizza and Chinese takeout is going to send you into a downward spiral. If you neglect your physical well being your mental acuity will soon decline. Think of this as a necessary head clearer. Prioritize you hobby's. For some people knitting can probably be abandoned for a few weeks. For others that is just not possible. This is a marathon not a sprint.

Please be respectful of each and do not use foul language. We're all in this thing together so play nice.

Post your thoughts and questions - i will try and answer as fast as I can

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    • FreshSquids profile image


      8 years ago

      Looks like a plan! Hope all goes well with your exams!

    • MiriamS profile imageAUTHOR


      8 years ago

      Hi there Dr. Arjun. That is a topic out of the scope of this lens, but stay tuned for future lenses on such issues. It is crucial for IMGs to pass the USMLE on their first try. For a competitive residency like surgery you want to score very well (240+) if you are a foreign grad.

    • profile image


      8 years ago

      Thank you for all the details and i being an IMG i wanted to know about the chances of a residency in surgery???


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