How to Integrate Step 1 Studying During School

In this post, I share how I integrated Step 1 studying throughout the school year alongside classes. Remember that only YOU know how YOU study best! What works for me may not work for you, but definitely talk to as many upperclassmen as possible to see the different strategies out there, and then modify it to your liking. My strategy is based on spaced repetition with Anki and multiple passes of of class material.

Notes:

Every medical school’s curriculum will be different. While other schools focus on Step 1 material in their classes, my school is known for emphasizing clinical knowledge and skills. This can make it difficult to study for Step 1 during school. Discipline and time management is key!

Our pre-clinical curriculum is only 3 semesters, which is shorter than other schools. The first semester focused on Foundational Sciences and the second and third semesters were our Organ System blocks (modules, units). This is also why I started Step 1 prep earlier!

For your reference, I scored a 245-250 on Step 1 and performed above average on most class exams. See my related post on how I studied for Step 1.

Workflow for Foundational Sciences

FYI: I did not use Anki my first semester!

1. Watch/attend lectures + take notes (first pass of material)
   • Depending on whether you are a class go-er or not!
2. Review lectures again (second pass).
3. Work on Study Guide for class (third pass)
   • I made a study guide for myself of all the material that’s taught in class, but is NOT in First Aid.
   • The purpose of this study guide is to cover material that may be on the class exam, but isn’t necessarily boards relevant.
4. Watch Sketchy Micro if on the Micro block, instead of creating Class Study Guide.
5. If on Pathology block, watch the relevant Pathoma videos a few days before the exam.
   • Pathoma is more of a summary of the high yield concepts, which is why it’s great for high yield review before an exam.
6. Review relevant First Aid sections couple days before an exam.
   • Like Pathoma, First Aid is an outline of high yield points. Good for review before an exam.
   • Biochemistry and Genetics sections are great!

Workflow for Organ System Blocks

My workflow for the organ system blocks is based on Med Shamim’s method using Anki. Note: No need to download Load Balancer.

1. Watch/attend lectures + take notes (first pass)
   • Depends if you are a class goer or not.
2. Search Anki deck for cards related to class material (second pass) and un-suspend them. Move cards to a deck labeled, “Current Class”.
   • Whichever deck you use, you should suspend ALL the cards at first and then un-suspend cards as you learn concepts from class.
   • Eventually, when the block is over, you will move all the cards from “Current Class” to “Combined Review” or whatever you want to name it! The “Combined Review’ deck contains all the cards from your past blocks/classes.
   • You will probably have cards that are still suspended either because you didn’t catch them or you didn’t learn them in class. You should still unsuspend them and move them to the “Combined Review” deck because you still need to know them for boards.
3. Every day, review cards from “Combined Review” deck, which contains cards completed from previous blocks.
   • At a minimum, I would TRY to do 50 old and 50 new ones (Med Shamim’s method)
4. Watch relevant Pathoma video, take notes in the text, unsuspend Anki cards (time permitting!)
   • The Zanki/Anking Deck organizes Pathoma videos by tag, which makes it easier to unsuspend them because you don’t have to search the cards. Just highlight all the cards under the tag and unsuspend!
5. Watch Sketchy Pharm if learned drugs.
   • I used Zanki because I didn’t know about the Anking Deck yet. But I recommend the Anking Deck because the Sketchy Pharm videos are organized by tags!
6. Do new Anki cards that were un-suspended (the next morning)
7. 3 to 4 days before an exam, focus on class material ONLY and create study guide (third pass). You do not have to keep up with the reviews from the Combined Deck.
   • This step can be optional. Some people only need 1 or 2 passes through the material, but I need a 3rd pass!
   • This step also requires you to be caught up on all lectures.
   • Typically, I would divide the number of PowerPoints there were by 3 or 4 (days until the exam), to see how many I’d have to review each day. Usually it was about 5-6 lectures.
   • During my third-pass, I created a study guide containing material that I did not see in Anki, First Aid, or any other of the Boards resources I was using. That way, I could still be familiar with class material that might show up on the class exam. I’d skim the entire study guide the day before the exam.
8. 1-2 days before an exam, read First Aid and BRS Physiology as a high yield review.
9. At the end of the block, move all your cards from “Current” deck to the “Combined Review” deck.
10. Repeat! Keep doing cards from the Combined Review deck along with your Current Class deck.

General Notes

• Doing Anki every day, even if you can’t keep up with all the reviews, is the key!
• Integrating Step 1 studying during school requires time management and discipline!
• BUT you should always prioritize your mental health and passing your classes first! Step 1 studying is NOT a priority until a few months before your test date.
• Do not feel like you have to follow my method! Even a little bit of Step studying every day helps!
• My intention isn’t to stress you out, but to relieve the stress of studying during dedicated.

What I Would Have Done Differently

1. Watch Sketchy Pharm starting from first organ system block (I started halfway through organ systems).
2. Start Anki from Day 1 using Anking’s deck (instead of second semester of MS1 using Zanki’s deck).
3. Learned how to use filtered decks and how to use the “cram” option, which is a feature on Anki that allows you to study all the cards before an exam without changing the scheduling of the card itself.
4. Consider watching Boards & Beyond.

Helpful Videos by Anking Med

How to Find Relevant Cards with Anki
How to Use Anki for Med School

Let me know if you have any questions! I know Anki can be confusing to navigate and overwhelming so I’d be happy to answer any questions you might have!

Check out my related posts:
Anki for Dummies
How I Studied for Step 1

With lobe,

Kelly

Kelly

Internal medicine resident physician at UCLA, primary care track. VCU School of Medicine c/o 2022. SoCal born and raised.

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