USMLE 260+ Step 1 Study Plan

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Hey everyone,

I used SDN a lot during the time I studied for Step 1 and thought I would pay it forward. I have listed my resources, a detailed study plan, and Q Bank averages, practice test, and official Step 1 score. My test day was early-mid April.

Resources used:
First Aid
Sketchy Micro and Pharm
Pathoma
Kaplan Q Bank
USMLE Rx Q Bank
UWorld Q Bank

Study Schedule:
Late September--Mid January:
During second year my school taught us each organ system, one at a time. We were tested on 3 major organ systems at a time, and each subsequent test was cumulative from the beginning of the year. For example, if the first three organ systems were Cardio, Resp, and Renal, the first test only tested those 3 systems. If the the next 3 were GI, Repro, and Endo, then the 2nd test focused most of its energies on GI, Repro, and Endo with questions also covering Cardio, Resp, and Renal. So it was in my best interest to keep reviewing old organ systems while learning new ones at the same time. Also keep in mind that all my tests were official NBME exams, so studying for exams was much like studying for Step and I didn't need to focus too much on the nitty gritty details taught in class.

FA, Pathoma, Sketchy
I did not go to class during 2nd year at all (except required ones), so initially I would quickly watch the recorded lectures at home and then go through the corresponding section in First Aid. However, I quickly realized that even watching was a waste of time because half the time I would space out and just read the slides. So I started just scrolling through lecture slides to make sure I didn't miss anything big that was not in First Aid. I would take about a week to get through one organ system in First Aid and then a few days to get through Pathoma. I took notes in Pathoma but not really in First Aid except for some underlining or definitions of words or abbreviations I did not know. I also watched the Cardio drug videos in Sketchy Pharm as I learned them through FA and made a goal to watch a few sketchy videos per day, mixing the relevant Pharm drugs and just doing the micro ones in order. I had done Micro during first year so this was for review. I remember I counted the number of total micro+pharm videos and decided I wanted to get through all of them once by mid February and then just did a certain number per day to reach that goal.

Kaplan Q Bank
Once I had gotten through the chapter in FA and Pathoma, I started doing questions in Kaplan Q Bank. I did it by organ system, so again if Cardio was my first one, I only did Cardio questions. I tried to finish all the Cardio questions by the time the next organ system came around. I made a journal of wrong answers and tried to periodically review it if I had some time (though realistically I did not have too much time and the process of writing down the key points seemed to be enough to solidify it). The journal would make a question out of the point that I missed: "Why does a VSD murmur not present until a few days after birth?" and then I would write the answer. The actual question in the Q bank was much longer and was a 3rd order question, but in my journal I boiled it down to the key fact that I did not know.

USMLE Rx Q Bank
If the next organ system was Resp, I did the same thing and did the FA and Pathoma chapters in Resp. I then did the Resp questions in Kaplan Q bank. However, by the time the test came around, I had finished all 3 organ systems in Kaplan Q Bank and needed another one to review all 3 in a mixed question format. I bought USMLE Rx, and would do them timed and mixed with the 3 organ systems so get practice for the upcoming NBME exam. I made a journal for these questions too. I did the combination of Kaplan and Rx for all my exams. Before each exam, I was also able to quickly read each FA chapter and watch the Pathoma video on 2 speed for the organ systems that were being tested.

Mid January--Mid February
My school was giving an official CBSE practice test in Mid February. We were still learning some organ systems all the way up until that point, but because I had gotten a system down and was essentially not even reviewing slides anymore, I had time to mix in the Pathoma and FA chapters I had not learned yet. I did all the chapters at the beginning of FA, in conjunction with the non organ system chapters of Pathoma, skipping only the Micro chapter along the way. I also worked in the Kaplan and RX questions. I honestly did not have too much time to really learn these chapters in super detail like I had with the organ systems, but I wanted to at least see the stuff once before my practice test. With all of this, I was in good shape

Mid February--April
During this time, I bought UWorld, and made a schedule to get through one FA chapter or pathoma chapter per day, as well as do 3 blocks of UWorld per day. I ended up having to take half days off to get some breaks, but then just had to modify my schedule later to maybe pair an easy pathoma chapter with an easy FA chapter so I could catch up. On some days I only did 2 blocks of UWorld if I was feeling too tired. The UWorld questions were all mixed and timed and I again made a journal of wrong answers as I had done for Kaplan and Rx. The plan was to get through Pathoma once and FA twice before the exam and finish UWorld a week before the exam. In this time I learned all the tiny tiny details, as I had gone through FA and pathoma numerous times during the school year as I was studying for my tests. I also was able to watch all of Sketchy Pharm and Micro one more time, by doing about 5 videos per day. I also took both UWorld Practice Tests and did all 6 NBME exams (4 timed, 2 offline). On practice test days, I did not do any studying.

Test Scores:
Kaplan Average: 67
USMLE Rx Average: 77
UWorld Average: 81
CBSE (2 month before test): 230
UWorld Form 1 (1.5 months before test): 256
NBME 16 (1 month before test): 230 (freaked out but I also had messed up timing during the test and lost 15 min from one of the sections)
UWorld Form 2 (3.5 weeks before test): 247
NBME 13 (3 weeks before test): 250
NBME 15 (2.5 weeks before test): 259
USMLE Free (2 weeks before test): 90%
NBME 19 (1.5 weeks before test): 252
NBME 17 (1 week before test)--offline/self timed to see questions and time management
NBME 18 (4 days before test)--offline/self timed to see questions and time management
USMLE Step 1 Official Score: 261

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Ugh I just started Kaplan but I'm not doing so great (52%), im doing it by system as I go through the curriculum but 4-5 out of 15 question set are always materia that I haven't covered. Is it best to hold off on qbank until the end of the block, then just do as many as I can? Congrats on your score!!
 
I think it probably depends on how you best learn; for me, doing questions and taking notes on them was the greatest way to solidify a concept. It would force me to go find the topic in First Aid and read about it. But if you get overwhelmed when you don't know some information, you could always wait to do it until after you have learned it..I don't think you can really go wrong either way.
 
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Ugh I just started Kaplan but I'm not doing so great (52%), im doing it by system as I go through the curriculum but 4-5 out of 15 question set are always materia that I haven't covered. Is it best to hold off on qbank until the end of the block, then just do as many as I can? Congrats on your score!!
I try to get through as much of the FA material as possible right in the beginning. I start each block with a full day of Pathoma and FA, covering all the material for the block (we do 2-3 weeks, then test only that block, so not like OP). Obviously, a lot of it doesn't stick, but at least I've glanced over it. Words look familiar, and I can get to the most valuable part of studying earlier, which is switching back and forth between application and review (essentially the process that Qbanks automate for you). I also start the Zanki cards for that section, trying to front-load the block with new cards. When I'm ~50% through the cards, I start questions. I usually start around 60% and by the end of the block I'm at pretty consistent 80%-100% on 10 question blocks.

I don't kill my class exams, but I also go to a true P/F school. I also blow off a lot of clinical material (i.e. work for our P/F physical exam class) because I'm MD/PhD and will forget all of that by the time I hit the wards.
 
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Hey everyone,

I used SDN a lot during the time I studied for Step 1 and thought I would pay it forward. I have listed my resources, a detailed study plan, and Q Bank averages, practice test, and official Step 1 score. My test day was early-mid April.

Resources used:
First Aid
Sketchy Micro and Pharm
Pathoma
Kaplan Q Bank
USMLE Rx Q Bank
UWorld Q Bank

Study Schedule:
Late September--Mid January:
During second year my school taught us each organ system, one at a time. We were tested on 3 major organ systems at a time, and each subsequent test was cumulative from the beginning of the year. For example, if the first three organ systems were Cardio, Resp, and Renal, the first test only tested those 3 systems. If the the next 3 were GI, Repro, and Endo, then the 2nd test focused most of its energies on GI, Repro, and Endo with questions also covering Cardio, Resp, and Renal. So it was in my best interest to keep reviewing old organ systems while learning new ones at the same time. Also keep in mind that all my tests were official NBME exams, so studying for exams was much like studying for Step and I didn't need to focus too much on the nitty gritty details taught in class.

FA, Pathoma, Sketchy
I did not go to class during 2nd year at all (except required ones), so initially I would quickly watch the recorded lectures at home and then go through the corresponding section in First Aid. However, I quickly realized that even watching was a waste of time because half the time I would space out and just read the slides. So I started just scrolling through lecture slides to make sure I didn't miss anything big that was not in First Aid. I would take about a week to get through one organ system in First Aid and then a few days to get through Pathoma. I took notes in Pathoma but not really in First Aid except for some underlining or definitions of words or abbreviations I did not know. I also watched the Cardio drug videos in Sketchy Pharm as I learned them through FA and made a goal to watch a few sketchy videos per day, mixing the relevant Pharm drugs and just doing the micro ones in order. I had done Micro during first year so this was for review. I remember I counted the number of total micro+pharm videos and decided I wanted to get through all of them once by mid February and then just did a certain number per day to reach that goal.

Kaplan Q Bank
Once I had gotten through the chapter in FA and Pathoma, I started doing questions in Kaplan Q Bank. I did it by organ system, so again if Cardio was my first one, I only did Cardio questions. I tried to finish all the Cardio questions by the time the next organ system came around. I made a journal of wrong answers and tried to periodically review it if I had some time (though realistically I did not have too much time and the process of writing down the key points seemed to be enough to solidify it). The journal would make a question out of the point that I missed: "Why does a VSD murmur not present until a few days after birth?" and then I would write the answer. The actual question in the Q bank was much longer and was a 3rd order question, but in my journal I boiled it down to the key fact that I did not know.

USMLE Rx Q Bank
If the next organ system was Resp, I did the same thing and did the FA and Pathoma chapters in Resp. I then did the Resp questions in Kaplan Q bank. However, by the time the test came around, I had finished all 3 organ systems in Kaplan Q Bank and needed another one to review all 3 in a mixed question format. I bought USMLE Rx, and would do them timed and mixed with the 3 organ systems so get practice for the upcoming NBME exam. I made a journal for these questions too. I did the combination of Kaplan and Rx for all my exams. Before each exam, I was also able to quickly read each FA chapter and watch the Pathoma video on 2 speed for the organ systems that were being tested.

Mid January--Mid February
My school was giving an official CBSE practice test in Mid February. We were still learning some organ systems all the way up until that point, but because I had gotten a system down and was essentially not even reviewing slides anymore, I had time to mix in the Pathoma and FA chapters I had not learned yet. I did all the chapters at the beginning of FA, in conjunction with the non organ system chapters of Pathoma, skipping only the Micro chapter along the way. I also worked in the Kaplan and RX questions. I honestly did not have too much time to really learn these chapters in super detail like I had with the organ systems, but I wanted to at least see the stuff once before my practice test. With all of this, I was in good shape

Mid February--April
During this time, I bought UWorld, and made a schedule to get through one FA chapter or pathoma chapter per day, as well as do 3 blocks of UWorld per day. I ended up having to take half days off to get some breaks, but then just had to modify my schedule later to maybe pair an easy pathoma chapter with an easy FA chapter so I could catch up. On some days I only did 2 blocks of UWorld if I was feeling too tired. The UWorld questions were all mixed and timed and I again made a journal of wrong answers as I had done for Kaplan and Rx. The plan was to get through Pathoma once and FA twice before the exam and finish UWorld a week before the exam. In this time I learned all the tiny tiny details, as I had gone through FA and pathoma numerous times during the school year as I was studying for my tests. I also was able to watch all of Sketchy Pharm and Micro one more time, by doing about 5 videos per day. I also took both UWorld Practice Tests and did all 6 NBME exams (4 timed, 2 offline). On practice test days, I did not do any studying.

Test Scores:
Kaplan Average: 67
USMLE Rx Average: 77
UWorld Average: 81
CBSE (2 month before test): 230
UWorld Form 1 (1.5 months before test): 256
NBME 16 (1 month before test): 230 (freaked out but I also had messed up timing during the test and lost 15 min from one of the sections)
UWorld Form 2 (3.5 weeks before test): 247
NBME 13 (3 weeks before test): 250
NBME 15 (2.5 weeks before test): 259
USMLE Free (2 weeks before test): 90%
NBME 19 (1.5 weeks before test): 252
NBME 17 (1 week before test)--offline/self timed to see questions and time management
NBME 18 (4 days before test)--offline/self timed to see questions and time management
USMLE Step 1 Official Score: 261

Good job on killing that Step 1 out of the ballpark. I have a similar study plan and am consistently put in 6-8 hrs of work on that UFAPS along w/ the Kaplan and USMLERX Banks everyday. I hope to come close to your score when it's showtime.
 
Ugh I just started Kaplan but I'm not doing so great (52%), im doing it by system as I go through the curriculum but 4-5 out of 15 question set are always materia that I haven't covered. Is it best to hold off on qbank until the end of the block, then just do as many as I can? Congrats on your score!!

I personally hold off on those qbank quests until I go through anatomy, physiology, and pathology on FA. There's no point to score 50-60%. Use those banks #s as a measuring benchmark for your real potential. I average bet 70-85% on blocks of 30-40 quests when I hit the banks.
 
Thank you for this! I was wondering how frequently you would miss questions on class exams because they said something in lecture that you didn't get to hear. It seems for me that there are lots of clarifications made in class lectures that aren't readily noticeable just by looking at class slides. Did you ever watch lectures at all? I'm a little hesitant on abandoning watching lectures even though I feel like I need to because they take too long to get through each day
 
Thanks for writing this. Not enough people give credit where credit is due.
 
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Hi,

i am trying to come up with a schedule from now until june when i take step 1. i have boards and beyond, FA, pathoma, sketchy, and usmle-rx. how do i organize what to do first? what topics do i cover first?
 
Hi,

i am trying to come up with a schedule from now until june when i take step 1. i have boards and beyond, FA, pathoma, sketchy, and usmle-rx. how do i organize what to do first? what topics do i cover first?

I covered all the major organ systems first and just tried to do one a day (or for longer chapters 1 over 2 days) and then I prioritized higher yield subjects like Biochem and Immunology. Tbh though, it was just kind of random cause by the end of it I still had to review each chapter more than once.
 
Great job! Quick question --> how's the CBSE like? The sample questions offered by the NBME on their website seem pretty easy/first-order with a lot of buzzwords. I have to believe the actual CBSE is harder but I wasn't sure. If you don't remember it's all good!
 
Great job! Quick question --> how's the CBSE like? The sample questions offered by the NBME on their website seem pretty easy/first-order with a lot of buzzwords. I have to believe the actual CBSE is harder but I wasn't sure. If you don't remember it's all good!

It’s hard to remember specifics but I can recall walking out of it thinking “hmm that wasn’t that bad.” The CBSE is pretty similar to any of the official NBME questions you can find online since all of these are just using retired questions from the actual exam. It was definitely easier than any Q Bank I did!
 
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If one is taking a gap year and has 6 months prior to medical school with some free time. Would you suggest reviewing First Aid and trying to do Kaplan QPack Questions? I glanced over a first aid pdf and felt strong about the biochem, microbio, and have a general understanding of all the systems due to my biology major and having taken the MCAT. Do you think it'd be helpful to do the questions to help myself review and learn content before classes start? For the MCAT, I just hammered a ton of practice and reviewed them extensively with notes that's how I got content to stick so I am thinking to do the same again for the STEP
 
If one is taking a gap year and has 6 months prior to medical school with some free time. Would you suggest reviewing First Aid and trying to do Kaplan QPack Questions? I glanced over a first aid pdf and felt strong about the biochem, microbio, and have a general understanding of all the systems due to my biology major and having taken the MCAT. Do you think it'd be helpful to do the questions to help myself review and learn content before classes start? For the MCAT, I just hammered a ton of practice and reviewed them extensively with notes that's how I got content to stick so I am thinking to do the same again for the STEP

I personally think it is way too early to start studying for step before first year. First Aid would seem so overwhelming without learning organ systems from class first, but even if you did manage to learn it, you might forget most of it when starting first year classes and having to study for those tests. I would just enjoy the time before school starts and not worry about step yet.
 
I personally think it is way too early to start studying for step before first year. First Aid would seem so overwhelming without learning organ systems from class first, but even if you did manage to learn it, you might forget most of it when starting first year classes and having to study for those tests. I would just enjoy the time before school starts and not worry about step yet.
Thanks for the reply. I actually took microbio and biochem in college and know the basics of organ systems due to my MCAT and college studying. I am considering maybe just reviewing microbio, biochem, and the basics of organ systems with first aid and sketchy maybe. What do you think about that? Also the ethics portion of first aid doesn't seem too bad either. But I will try to relax and enjoy my gap year.

I got a pdf of first aid online and feel like i know all the biochem and the most of the microbio. I was thinking about just reviewing microbio, biochem, organ systems and ethics in first aid and practice questions in a kaplan qbank regarding biochem and microbio just to reinforce it before school.

I won't focus on the drugs and illnesses as I know none of that.

TL;dr What do you think about just reviewing things I already know such as biochem, microbio, and the basics of organ systems as well as learning the ethics portion of first aid and supplementing that with kaplan qbank questions? Maybe I would even try out microbio. I would use USMLE rx during my first 2 years and then use Uworld qbank during my dedicated
 
If one is taking a gap year and has 6 months prior to medical school with some free time. Would you suggest reviewing First Aid and trying to do Kaplan QPack Questions

TL;dr What do you think about just reviewing things I already know such as biochem, microbio, and the basics of organ systems as well as learning the ethics portion of first aid and supplementing that with kaplan qbank questions? Maybe I would even try out microbio. I would use USMLE rx during my first 2 years and then use Uworld qbank during my dedicated

God no. Full stop.
 
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Thanks for the reply. I actually took microbio and biochem in college and know the basics of organ systems due to my MCAT and college studying. I am considering maybe just reviewing microbio, biochem, and the basics of organ systems with first aid and sketchy maybe. What do you think about that? Also the ethics portion of first aid doesn't seem too bad either. But I will try to relax and enjoy my gap year.

I got a pdf of first aid online and feel like i know all the biochem and the most of the microbio. I was thinking about just reviewing microbio, biochem, organ systems and ethics in first aid and practice questions in a kaplan qbank regarding biochem and microbio just to reinforce it before school.

I won't focus on the drugs and illnesses as I know none of that.

TL;dr What do you think about just reviewing things I already know such as biochem, microbio, and the basics of organ systems as well as learning the ethics portion of first aid and supplementing that with kaplan qbank questions? Maybe I would even try out microbio. I would use USMLE rx during my first 2 years and then use Uworld qbank during my dedicated

You will become god tier at consuming knowledge during the first 2 years of preclinicals. Don’t start the buffet until you have to.
 
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Might still do it tho

Don't. As a student preparing to take boards in 7 months, don't do it. It's not worth it. You will have more than enough time to prepare and will regret wasting your time doing it now. Not to mention it would be a complete waste of valuable board practice questions.
 
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Don't. As a student preparing to take boards in 7 months, don't do it. It's not worth it. You will have more than enough time to prepare and will regret wasting your time doing it now. Not to mention it would be a complete waste of valuable board practice questions.
I would be using the Kaplan qbank during the gap. USMLE Rx during school. And Uworld during dedicated. Prob will only get to do a few hundred during the gap. I mean that's like a total of 6000 questions. I doubt I can go through so many in 2 years on top of classes and stuff
 
Don't. As a student preparing to take boards in 7 months, don't do it. It's not worth it. You will have more than enough time to prepare and will regret wasting your time doing it now. Not to mention it would be a complete waste of valuable board practice questions.

Pre meds know everything, how did you forget?
 
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Ok I get it guys lol. Just a little anxious and excited. I'm hoping I can make things easier come med school time
 
Yeah so that's why I'm not afraid to waste the kaplan qbbank questions yaknow. I still got usmle rx and uworld

If you absolutely must pre-study, and you want it to actually stick and not be a waste of time, use something like Zanki/Bros/Lightyear/Firecracker. The problem with using a QBank is not only that you waste high quality questions, but that you won't retain what you learn in the long term after seeing a question once in isolation. If you start Zanki now and keep hammering the reviews throughout M1 and M2 you'll be in better shape.

Spaced repetition of material builds your foundation, and QBanks solidify and fill in gaps. You don't have the foundation built yet so you won't get much out of doing QBanks, IMO.
 
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If you absolutely must pre-study, and you want it to actually stick and not be a waste of time, use something like Zanki/Bros/Lightyear/Firecracker. The problem with using a QBank is not only that you waste high quality questions, but that you won't retain what you learn in the long term after seeing a question once in isolation. If you start Zanki now and keep hammering the reviews throughout M1 and M2 you'll be in better shape.

Spaced repetition of material builds your foundation, and QBanks solidify and fill in gaps. You don't have the foundation built yet so you won't get much out of doing QBanks, IMO.
Gotcha. I'll keep this in mind moving forward. Thank you
 
Ill actually give a different take. If you must prestudy, id suggest do it by organ system.
Learn everything about physio + patho for lungs, renal, heart and endocrine - and NOTHING else until you are maximally competent in those areas. If you know those systems inside out, it will really help you understand most tie ins to problems that arise. That alone will take a few months to master.
 
Ill actually give a different take. If you must prestudy, id suggest do it by organ system.
Learn everything about physio + patho for lungs, renal, heart and endocrine - and NOTHING else until you are maximally competent in those areas. If you know those systems inside out, it will really help you understand most tie ins to problems that arise. That alone will take a few months to master.
Thank you
 
Thanks for the post. My school has mandatory attendance so I feel very strapped for time when it comes to board prep. I'm currently in renal/heme/derm block and will have GI/edo and Repro before dedicated board studying from mid April till test day in June/July.

This past 2 weeks I've actually gotten "serious" about review and board prep and have started doing 40 combank usmle questions per day (usually 20 review and 20 current block). I then note the topics I'm getting wrong and then reference FA/pathoma/sketchy. I'm still paying attention in lecture and making anki for each lecture. I spend 2 hrs in the morning on board stuff and then start lecture and studying for school exams. Our school exams are very nit-picky and not board-style/FA stuff. I plan on upping my boards time and trying to decrease class material time over the nect month or so.

As for my study schedule I've went back to previous block stuff like MSK and micro and do small blocks of those question and then review the material I get wrong. Would you suggest continuing to hit review questions and going thru material that I am getting wrong or would you suggest going thru all of the material for the topic and then hitting questions (i.e. FA, sketchy, and pathoma for MSK then a bunch of MSK questions).

As for the material we are covering in class I plan on transitioning to you plan of front loading it during the break between blocks or week 1 and doing all the FA/pathoma so that I don't waste time/questions on material that I don't know. I feel like I've wasted some renal questions because I did them as we learned material and ended up not even recognizing the bulk of topics.

Thanks!
 
I appreciate this post. I've been doing something similar: Using only Kaplan and USMLE-RX to study for exams, which are NBME. I was curious if you reviewed M1 material in depth at all during the September to mid January period. I know you studied relevant M1 material for the current block, but how about like flat out review of M1 stuff?
 
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Never went back to M1 material. Fortunately (or unfortunately depending on how you look at it), everything that you need to know from M1 is in FA and the QBanks already.
 
1 a week seems about right! I stopped officially taking them once my score was in the range I wanted, because 1) they are expensive and 2) I didn’t want to lose confidence if the score dropped.
 
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