USMLE STEP 1 Words of Wisdom

Now that STEP 1 is finally behind me, I’m excited to share some REAL advice about taking this exam. I’m talking about the stuff that I wish more people had told me (or the things that they did tell me, but I actually should have listened to).

I’m not going to sugarcoat things, studying for this exam was one of the toughest parts of my medical school career. I don’t know anyone that has a good time pulling 12+ hour study days, isolating themselves to a desk, and feeling like your future in medicine depends on this one exam (spoiler alert: it doesn’t). Hearing all the horror stories from students that came before me or thinking about my previous standardized test experiences (*cough* the MCAT *cough*) had me SHOOK even before I started dedicated. However, reminding myself of how hard I worked during medical school and everything I had to overcome, grounded me during those 6 weeks of studying.

Before reading this post, I just want to stress the point that during this process, everyone and their momma will have advice to give. Take each piece of advice with a grain of salt (including mine) and do what’s best for you. At the end of the day, you have gathered years of experience with studying and taking exams. What works for me, might not work for you – and that’s OK! You have gotten this far because you are intelligent, capable, and hardworking… remember that.

1. Stop Comparing Yourself

We all know that comparison is the thief of joy, but during dedicated it can be the thief of your sanity. Between listening to classmates rattle off their practice exam scores and hopping on MedReddit (where it seems as if everyone has a 260 baseline), there are many, many opportunities to compare yourself to others.


For starters, we each start off with different levels of expertise in test taking, different baseline scores, different amounts of time for dedicated, different use of study resources – you get the picture. Whenever I was tempted to compare myself to someone that had been using Anki since the start of MS1 year or who took 12 weeks for dedicated compared to my 6, I reminded myself that making such comparisons didn’t even make sense.

This journey is your own and looking around at what others do only serves as a distraction. If you remain focused on improvement within yourself, this period will be much less anxiety provoking.

2. Keep it Simple

There is a reason why UFAPS (a.ka. U-World, First Aid, Pathoma, and Sketchy) is the most talked about study method for STEP 1 – it works! However, what really matters is how you use these resources to master the massive amount of content that the exam covers.

Personally, the only resources that I believe are 100% necessary are U-World and First Aid – everything else is supplemental. Before beginning dedicated, it is important to pick your resources and stick to them. When you have a rough day and bomb every UW block, you will be tempted to add on another resource.  Fight this urge! There is only so much time and the fewer resources to get through, the better.

My most used resources were U-World, First Aid, Anki, Sketchy and Pixorixe. I supplemented with Pathoma for weaker topics.

3. Slow Progress, is Still Progress

It’s hard not to focus on numbers, especially when they get thrown in your face after every block or practice exam. Realistically, you are not going to see a 20-30 point increase between every practice exam. Instead, there will be slow and steady improvement. On average, my scores increased 10 points between each weekly practice exam.

Studying for this exam is truly a marathon, not a sprint.

By pacing yourself each day and sticking to a schedule that makes sense for you, you will see steady progress. If you are improving to any degree, be proud of that! I wish that I had celebrated the small wins more, instead of beating myself up when I didn’t see the score that I was hoping for.

4. Practice Scores Matter (To an Extent)

Since taking the exam, I’ve gotten dozens of DMs and emails asking me to “predict” how they’ll do on the real deal. There are even predictor calculators out there on Reddit.

No one practice exam will singlehandedly predict your real score.

However, you will most likely fall within a range of how you have scored on the 5-6 practice exams that you take during dedicated. For example, if most of your scores are in the 230 range, with some less than that and some higher than that, you will most likely score around a 230.

Also, do not bet on getting a score that you have never gotten on a practice exam. You will hear of people that “have a friend” that was barely passing on practice exams and miraculously scored a 230 on the real deal. These people are the exceptions, not the rule. If you are seriously aiming for a certain score, try to get at least two practice exams right around or above that goal before proceeding with taking the exam.

5. There Will Be Hard Days

My worst day happened around the 3-week mark. I had just taken an NBME and was hoping to hit a 230. I didn’t. I was exhausted and felt like I was working SO hard, but not seeing the results. I stress-cried, took the evening off and ordered takeout with my fiance.

The next week, I hit above a 230.

You will have days where you feel like giving up or thinking that there is no way you will achieve your goal. This is a normal part of the process. Take time off when you need to (you should already have time off built in your schedule btw), but it’s also important to push through days like these because you will have them.  

I really hope that this post helps someone, especially those that are particularly anxious about STEP 1. Thousands of students have done this before you, so there’s no reason to believe that you can’t! These can be trying times, but they are temporary. Believe in yourself, because I believe in each and every one of you reading this

Next week, look out for my post on my schedule break down. In the meantime, feel free to drop any questions in the comments.

Best of luck!

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