Hey everyone,

When I was preparing to study for Step 1 I couldn't find a thorough explanation on a study plan. I've received my score of 249, so I decided to write this post and help others by sharing my experience. This will be a LONG post so forgive me but I really think it could help you on your path.

First of all, I was aiming for a score of 240 or higher since I hope to match in a very competitive specialty. I'm an IMG so I knew that it would take more work and time than US medical students due to different medical education systems. Therefore, I think your first step is to make up your mind and fix a date for your exam. Many people can take from 3 months up to a year, depending on your learning capacities and previous knowledge. I think a total of 6 months is more than enough to fully prepare for Step 1. Once you set your mind on a date, work for it no matter what. This will be a moment to sacrifice friends, family, and free time but believe me it is worth it.

My technique was dividing my study into four phases:
Phase 1 - First reading of material, without active memorization.
Phase 2 - Second reading, memorization, and Kaplan Q Bank
Phase 3 - UWorld Q Bank
Phase 4 - Final Review

The material I used was:
- Kaplan Lecture Notes and Videos: Great material, has all the information you need to know (probably except pathology)
- BRS Rapid Review Physiology: Excellent, concise and easy to learn
- Goljan's Pathology: a MUST, great pathology review
- Kaplan Q Bank: not as good as UWorld but great for learning
- First Aid USMLE Step 1: your BIBLE
- UWorld Q Bank

PHASE 1 (2-3 months)

So I started off by reading all Kaplan Lecture Notes at the SAME TIME as I was watching the Lecture Videos. Some people recommend doing one reading and THEN watching the videos but in my opinion this is a waste of your time. You can easily do both at the same time. Some people also recommend to start reading the books with your weaknesses. However, I decided to do it in a LOGICAL order, just as you study them during med school. I started with Anatomy, then biochemistry/molecular biology, then immunology and microbiology, physiology, pathology, pharmacology and finally psychiatry/ethics. I ALWAYS used a pencil (you will understand why later on) to take notes and underline any important information. I recommend you put a daily goal in pages (like 60 or 70 pages per day) instead of time. This took me about 2 months and I focused my energy on reading and understanding, NOT actively memorizing.

Next step was strengthening Kaplan's weaknesses, so I decided to read BRS Rapid Review Physiology and Goljan's Pathology. This took me about 3 weeks total.

After finishing that I read First Aid cover to cover for the first time, WITHOUT highlighting anything (1 week) and WITHOUT memorizing.

After I finished reading all the material, I did Kaplan's Diagnostic Exam to get to know question style (scored 60%).

PHASE 2 (1-2 months)

This phase was to consolidate knowledge and do a first try at memorisation. To do so, I studied according to the different topics, instead of following a book order. For example Cardiology: I read the cardiology section in kaplan's anatomy lecture notes, cardiology section in physiology, cardiology section in pathology and cardiology section in pharmacology. At this point I did a parallel reading with Kaplan Lecture Notes and First Aid, reading ONLY what I had previously underlined and written in the margins. I made notes on my First Aid (WITH PENCIL) with any information I considered important. If there was a section in Kaplan's books that was completely absent in the First Aid, I used a highlighter in the Lecture notes. After reading everything on one topic (cardiology) and taking notes in the first aid, I memorized it and did ALL questions on Kaplan Q Bank on THAT subject (only cardiology). I did this for every topic until I covered all subjects in the exam.

For the Q bank I always used timed exams so I could start getting used to the time. I reviewed ALL answers (even the wrong ones) and wrote down any missing information in my First Aid (WITH PENCIL).

Some people find it easier to learn through flashcards, such as myself. I decided to write down flashcards on those topics which are easily forgotten and that are very precise. In case this works for you, I HIGHLY recommend doing flashcards on: immune deficiencies, enzyme deficiencies, vitamins, glomerulonephritis, vasculitis, microbiology, ALL pharmacology. I did one card per topic such as one per each vasculitis, one per bug, one per drug, etc.

After this phase I had already read my lecture notes twice, read my first aid twice, had notes on my first aid that were missing, read Goljan twice, and had COMPLETED the Kaplan Q Bank (all questions).

I did Kaplan's Simulated Exam 1 (scored 65%). Since this is an 8-hour simulated exam, my main purpose for doing it was to get to know my weaknesses during the exam regarding time, concentration, hunger, sleep, etc. To do this, I recommend you sleep well the night before, and take it as if it were your real exam. Don't worry, the score is neither important nor accurate.


PHASE 3 (1 month)

Here is where the clock start ticking, where things get real interesting and for me this is the MOST IMPORTANT PHASE, since it is with U World where you are really going to learn and memorize everything. This Q Bank is very similar to the real exam and it will certainly help you prepare for it. You will come to find that once you have a question wrong you will not forget it. I even think it is harder that the real exam. Once I started this phase I decided to set up a definite date on the exam, approximately 6 weeks after starting the U World Q Bank.

I woke up every morning and I completed 2 blocks (46 MIXED questions each, TIMED) in a row without stopping to correct the first one. I did this to get used to doing two blocks at the same time (like in the real exam). After finishing both blocks I corrected them. If I had the question right I didn't stop too long and only read the correct explanation. If I doubted between two options, I read both. If I had the question wrong, I read ALL options. HERE I HIGHLIGHTED MY FIRST AID AND WROTE CORRECTIONS WITH A PEN OR A COLOR DIFFERENT TO THE PENCIL.

4 weeks before my exam I did my first U World Simulation Exam (Scored 245). Read forums where people say these overestimate your score on around 15 points so I knew I had more studying to do.

2 weeks before my exam I did my second U World Simulation Exam (Scored 258). Subtracting 15 overestimating points that would give me 243, which was above my desired score so it was time to do my exam.

PHASE 4 (1-2 week)

At this point you must be finishing your U World Q Bank. After I finished it I wrote down a 2-week study plan to correct ALL questions I had wrong in UWorld and do a final THIRD LECTURE on First Aid. Obviously, I focused my attention on highlighted information and everything written in a pen (since this was the information learned from UWorld which is high-yield). I also went back to my kaplan lecture notes to read those VERY SHORT notes I had highlighted that weren't in the First Aid. I left for last those topics with the highest memorization requirements (microbiology and biochemistry).

The day before you must do ABSOLUTELY NO STUDYING and you must NOT oversleep. Just lay back, go to the movies, go to the gym, hang out with friends, anything but study. At this point you must be confident that you did your best studying and you must ACCEPT that there is still some stuff you won't know, and this is completely natural. Please, please rest and have a good night sleep the night before the exam, this is KEY to success.

On the day of the exam, there will be questions or topics you have never seen before. Don't panic, just take your best shot and continue. My recommendation for break time is:

- Blocks 1-2
- 5 minute break (have some fruit or chocolate with you, and a bottle of water)
- Block 3
- 5 minute break
- Block 4
- 15 minute break, lunch (have a salad or something very light so you don't get sleepy afterwards)
- Block 5
- 5 minute break
- Block 6
- 10 minute break
- Block 7 (I was exhausted and wasn't even reading thoroughly).

You may have noticed I have left out 5 minutes from break time, this is because you can take more or less in your breaks, so just to be sure.

If you are used to coffee, please do NOT stop drinking before or during your exam. Just keep doing the same things you normally do. Do NOT change habits.

After finishing the exam I felt relieved but also scared, I felt like I didn't do as well as I wanted and that night I panicked thinking I could fail. THIS IS NORMAL. Just try to relax until your results and DO NOT start looking for answers on your questions, this will only worsen the feeling and your anxiety.

After 3 weeks I received good news on my 249, which exceeded my expectations! My final recommendation: KEEP STRONG AND RELY ON YOUR MOTIVATION!!! DON'T GIVE UP!!!

Hope this guide helps and if you have any questions please let me know, I would be glad to help

Thank you!!! This study plan is GOLD for us IMGs!!

It is really a very interesting post and thank you so much for sharing your experience on USMLE examination. This would set people to get into their study materials soon.


usmle step 1
edited by on 12/1/2014
edited by on 12/1/2014

Congratulations on this brilliant score & thank you for this useful post.

For an IMG with a fair background. Besides, last time he studied the basic sciences in his medical school was 5 years ago.
A) What timeline would you recommend to finish this step from A-Z ?
B) How many months of UWorld subscription is enough ?
C) Should I build my study strategy on a fixed number of hours/daily or on a certain number of pages ?
edited by on 12/1/2014
edited by on 12/1/2014

I studied after graduating med school so the last time I'd seen basic sciences was about 4 years ago. So this won't be a problem. For your questions:
A) I don't understand what you're referring with "timeline", could you please be more specific?
B) As stated above, for me UWorld was the last step so I only required 2 months. 1 month can be enough if you are willing to do 3 blocks/day.
C) For the first phase I would recommend a certain number of pages (for me it was 70 pages per day. Some days were harder like microbiology and some were easier like ethics). For the second phase I would set a specific number of days per topic depending on difficulty (for example 2 days for psychiatry and 4-5 days for cardiology)

I mean by the timeline the whole preparation duration that I may need to finish this step from A to Z & willing to get a competitive score 245+. Knowing that I share you also that last time I studied for the basic sciences was 5 years ago. I may spend much time just memorizing very few pages.

As you can see, it took me about 6 months total if you can do at least 8-10 hours a day. You will come to see that memorizing stuff will be so much easier once you start doing the Q Banks. Before doing Q Banks learning everything is too hard and in my opinion just not worth your time. Q Banks are designed to make you learn in an active way instead of a passive one, so you will remember things easier.

So would you recommend doing Qbanks on daily basis from the start of studying ? or just finish this boring passive studying in the first three months then move to the online Qbanks in the last three months together with First Aid ?