I postponed step 1 and took it during my 2nd rotation. My first was surgery and my second was IM, inpatient, both services were super busy. I told them that I was taking step 1 and they understood that I'd have to study a lot but didn't give me much slack. I had 3 full days of surgery and 2 half days/week. When I got home all that I did was qbank, like 50-100. I did qbank in downtime and I had a FA on my tablet that I read. I spent my weekends studying sun up-sundown, but I scored 95th% on step 1 and landed my no 1 residency. Competitive university acgme IM. It all depends on what you're willing to sacrifice, but a month or 2 won't kill you, despite constant anxiety. Yeah those 2 months were pretty awful tho. pm me if you have questions. I didn't take usmle, though I did study for it through my 3rd rotation in case I didn't smoke the comlex. I also studied for comlex as if I were taking usmle(FA, Kaplan books, UW at the end)