So I took the Step 1 last month (yeah, I’m really late) and I wanted to write up my experience in hopes of helping anyone who is/was in the same boat as I was. If you’re looking for a post with a study schedule or how to approach each subject in detail, turn away now. Anas has a great post regarding that, and you can check that out. This post is more of a guide for those of you who are boycotting the USMLE like it’s Starbucks, those who are thinking about it but are lost or those of you who’ve gone through the 5 stages of grief and have started studying. Basically, I’m going to outline the many mistakes I made, so that you can avoid doing them, and mention the few things I did right. So let’s get to it.
My biggest mistake, without a shadow of a doubt, was waiting till internship year to take the exam. Throughout my medical school years, I was hinged on the fact that I would go to Canada. I avoided the USMLE like it was bacon. No seriously, if any of my friends brought it up, I’d change the subject or walk away. Finally, in 5th year I realized that the chance of getting into a residency in Canada was close to 0. I panicked for days and then finally decided I should probably start studying for the Step 1. If anyone reading this is in 3rd or 4th year, unless you’re a Saudi or you have a solid plan for residency, do NOT push away the exam. I can’t stress this enough. If I could go back in time, I would’ve started studying in my 2nd or 3rd year. A year from now, you’ll wish you started today. Stop pushing it away. This is THE biggest mistake I made, and I will always regret it.
Thinking of the exam as a big, bad monster. Is the Step 1 a difficult exam? Yes. Is it impossibly difficult? Not a chance. You need to get the idea of the exam being too difficult out of your head. This notion was the main reason I kept running away from the exam. My biggest advice is to find a friend who is serious about studying for the exam, this’ll help you realize the exam can be tackled and you’ll end up motivating each other. The sooner you realize you can do it; the sooner you can do it. The USMLE is not impossible. There are stories of students who did poorly during their med school years and ended up getting amazing scores. I myself was extremely lazy during my first 2 years, and was below average. What matters is how much hard work you’re willing to put in. If you study hard and study smart, 250 is easily achievable. One of my school teachers once told my class something that’s stuck with me for years. He said that none of us is “smarter” than the other, there are just those who work hard and those who don’t. I agree, there are the handful of geniuses that are lackadaisically smart and a few people who are below average, but the vast majority of us are equal in terms of intelligence. It just depends on how hard you’re willing to work.
Finishing my first read of FA late. I finished my first read of FA in the first week of August, around 2 months before my exam. If I could go back, I would’ve studied FA during 1st-3rd year with each subject so that I would’ve had a general idea of the knowledge. I was able to finish FA another 2 times before my exam, but if I started earlier, I could’ve done it a few more times.
Wasting time. During the year, I was only able to go through 4 organ systems + Biochem. Although a lot of that is attributed to time spent on the rotation I was doing, I also did waste a lot of free time. In the end, I look back and wish I didn’t waste as much time as I did.
Not studying in the summers I was free. If I could go back to the summers of third and fourth year, I would have spent some time studying, even if it was 2-3 hours a day. Don’t waste your whole summer, try studying even if it’s a couple of hours a day. It’ll play a role later on, trust me.
Not doing all the NBMEs. I was only able to do NBMEs 13, 14, 15 and 16. I was leaving 17 and 18 to the week before my exam, but ended up revising other things and didn’t have time for them. I did read NBME 17 off a forum, just so I could learn anything new. I ended up having a question copy-pasted from NBME 17 that I would not have gotten had I not read the form. There usually is 1-2 questions copied exactly from an NBME, so try your best to do them all.
Things I feel I did right:
Starting UWorld early in my prep. I bought a year subscription in October, and I was able to go through UWorld twice before it expired. When I look back, I’m really glad I start UWorld as early as I did. Although sometimes I would go 1-2 months without opening UWorld during the year due to our rotations, etc. I was still able to do around 40-50% during the year. Also remember: use UWorld as a learning tool, not an assessment tool. I was averaging less than 50% on Biochem during my first pass. It’s normal so don’t get discouraged. As long as you annotate FA or make a UWorld journal, whichever works for you, and you understand your mistake and learn from them.
Spending time on memorizing pathways, etc. and studying smart. This is probably tied for number 1. Studying smart and studying effectively for me was not trying to research “tips and tricks” on how to memorize things. Yes, mnemonics do help, but there’s a limit to what they’ll help in. You can’t use mnemonics to help you memorize the Urea or TCA cycle. They will help a bit, but in the end it’s all down to brute force and repetition. What I would do is take a blank piece of paper and write out whatever I could of a pathway from memory. Then I would open FA and fill in/correct all the things I missed. I did this with most of the Biochem pathways, and with the gram + and gram – charts in the micro section. You’ll mess up the first few times, but just keep at it. Every morning before you start your studying for the day, take 15-20 mins and draw out every high-yield Biochem pathway (gluconeogenesis, glycolysis, TCA cycle, Urea cycle, etc.) or anything else you have trouble remembering (tables, graphs, etc.) and after doing this for a week or two, it’ll be ingrained in your memory. This helped me more than I can explain.
So that’s basically it. If anyone has questions on what I did for prep, I’ll be happy to answer. I wanted to make this a little different than the usual UWorld + First Aid + Pathoma stuff you read everywhere. Remember to make a ton of dua, because nothing is possible without Allah’s help.
Work hard, pray harder and you’ll see the fruits of your efforts. Best of luck!