I just took Step 1 and would like to share my experience.
I’m an IMG at a non-Caribbean school. I had one month dedicated prep time, but I’ve been studying with Step 1 in mind since Day 1 of medical school. Since our curriculum was entirely systems based (Immunology -> MSK -> Resp -> etc.), I would spend the entire block reading the corresponding sections of First Aid, Pathoma, and Papa Robbins (the big one). I would supplement with Kaplan as needed for biochemistry and pharm, and I would aggressively seek out primary literature and other resources to fill in any gaps. (I actually spent a lot of time on Amazon looking for the best books on any given topic so I could grab a copy from the library. I also heavily abused UpToDate’s 30-day free trial policy.) My goal was to be an expert in everything related to the week’s PBL, such that I could explain from first principles the relevant pathophysiology and management. I would then finish each system with USMLERx to make sure I nailed the nitty-gritty details of First Aid. This worked pretty well for me, and I feel like I got a well-rounded education from a basic sciences as well as a clinical point of view. Yes, I knew the urea cycle but I could also read a CXR competently a la Felson's Principles of Chest Roentgenology. This ended up being a tremendous boon, as Step 1 turned out to be very clinically oriented.
My dedicated prep started in mid-January--
UWorld: 81% timed, random, first pass over three weeks. I felt pretty solid from a conceptual point of view, so I didn’t need to spend much time with Uworld, though it was a tremendous resource. I realized my biggest weaknesses were memorizing factoids and poor test-taking strategy. I blazed through questions. Blazed. I would finish NBMEs in less than two hours. Not ideal when you’re making dumb mistakes! I had some fine-tuning to do…
February 5th UWSA 2: 256
February 7th NBME 11: 247
February 12th UWSA 1: 262
February 18th NBME 12: 258
February 21st NBME 13: 242 (ouch)
February 23rd NBME 15: 252
Exam February 26th