Use search function. There is an entire thread dedicated to APMLE Part 1 for each year.
Dexter has even formatted it to specifically what each poster used and how long they studied for each section.
Many people who failed did not have the basics going in.
Some had personal family events that distracted them from dedicated studying
Some had test anxiety/test taking skill problems
Some simply did not put in enough time- all other aspects negligible- they simply did not put in enough hours.
The harder you study and train, the easier the test will feel. There is no way around it. It is built to trick you. As asinine as it is, it is also built to test you on what you should know.