Step 1 is the first part of the United States Medical Licensing Exam (USMLE) and arguably the most important exam of your medical school career. While other factors determine your competitiveness for your specialty of interest, your USMLE Step 1 score often guides what specialty you can go into. Unfortunately, many residencies use this score as a way to screen applicants since the number of spots for interviews and positions are limited.
Because of the importance of this exam, medical schools give students time off to study for this exam, which range from 4 to 8 weeks depending on the school. It is important to take advantage of this period! Good planning is the key to doing well on the exam, especially if standardized exams are your kryptonite. In this post, I share all of my knowledge in order to help ease some of your anxiety and help you succeed!
Note: Step 1 will become Pass/Fail starting 2022. Some speculate that more importance will be placed on Step 2 Clinical Knowledge instead!
For your reference, I scored between 245-250.
Other related posts you might find helpful!
– Optimizing Your Step 1 Dedicated Study Period
– How I Studied for Step 1
– How to Integrate Step 1 Studying Throughout the School Year
Identify your weaknesses.
If you haven’t already, take a look at your grades/transcript and identify which classes you struggled with. During your dedicated, be sure to carve out extra time on these weak areas!
Now, think about what you have historically struggled with the most. For me, it has always been physiology. For others, it may be pharmacology. Make note of this and be sure to spend more time on this during dedicated.
Talk to your dean’s, Step 1 advisers, etc.
Many medical schools have faculty that serve as Step 1 advisers. They look at your grades and help you identify weaknesses, then create a schedule and timeline for you based on your scheduled test date. At my school, it was mandatory for us to meet with our advisers. But if it is not required, I would still recommend reaching out to ask for their insight because their experiences with previous students can be highly valuable!
You can also create a schedule on your own if you know yourself well. My final schedule ended up being a combination of both my adviser’s and my own. I tailored the schedule that my adviser made to my own needs. For instance, I added more study time on certain topics, shortened my breaks, extended my study hours, and added NBME exams. Again, this will be totally up to you!
Make a list of resources you will use, but keep it as short as possible.
Avoiding resource overload is crucial for studying effectively and efficiently during dedicated. In general, it will be UWorld, First Aid, Sketchy, and Pathoma. You can supplement as needed with other resources, especially for your weak areas. You can find a list of all the resources I used here!
Figure out your approach to content review.
This will look different for everyone. You can find more on how to approach content review in my blog post here.
In summary:
- In general, you should be mainly focusing on content review and should NOT be learning new material.
- You will likely be reviewing First Aid every day. Some people watched Boards and Beyond videos every day.
- If you’re using Anki, you should keep up with reviews if you can.
- Each day you will be focusing on one topic, either a foundational science (physiology, pharmacology, etc.) or organ system.
- Sometimes they align, sometimes they don’t!
- You should be reviewing foundational sciences before organ systems!
- I highly recommend reviewing a little pharmacology every day!
Create your schedule ahead of time.
This can be the hardest part of preparing for dedicated, which is why I recommend consulting with your advisers! After you figure out what list of resources you’ll be using and your approach to content review, you can create a detailed schedule on an excel sheet. It took me a long time to create my schedule. You can find the details of my Dedicated Step 1 schedule here, along with tips for how to create yours!
- Calculate the total number of days you have for dedicated.
- Decide how many break days you want and subtract from total number.
- Now ask how much time you want to spend on each subject. Generally:
- Spend MORE time on: Physiology, Pathology, Microbiology, Pharmacology
- Spend LESS time on: Behavioral Science and Statistics, Immunology, Biochemistry, Neurology, Gross Anatomy and Embryology
- Spend MORE time on cardiology, pulmonology, and renal, however all other organ systems are variable depending on weaknesses.
- Look at your list of resources and calculate how many days you’ll be spending on each.
- For example, if Pathoma has 20 chapters and I’ve decided I’ll be spending 7 days on Pathology, then I will need to get through 3 chapters a day.
Figure out your optimal study environment!
Dedicated will be intense studying of 10-14 hours a day (depending on the person of course). Some questions to ask yourself:
- Will you be going home to study with the support of your family, who can prepare meals and do your laundry?
- Or will you be studying at home near school, where you may need to buy a meal plan for the next few weeks?
- Or do you have a partner you live with who can support you during this time?
- Do you study better in morning, at night, at library, or in your apartment/home?
Inform your loved ones.
Let them know that your availability during this time will be limited! Rather than leaving them in the dark, inform them that you may not be able to call or visit as often. I’m sure they will be more than understanding! Also tell them when your test date is so they know when you will be free!
Reassess the state of your mental health.
Last, but definitely not least, be honest with yourself and evaluate whether or not you have unaddressed mental health concerns that you’ve been putting off. Faking it until you make won’t work here. If test anxiety is something you struggle with (or any other mental health condition in general), seek help early on because it becomes very real on test day/throughout Dedicated. Studying for an exam this big is going to require a lot of brain power, so it only makes sense that you prioritize your mental health!
It’s a good idea to visit the counseling center if you find your anxiety/worries are impairing your function. Don’t be afraid! I will be the first to admit that this was my position. I knew I didn’t want to take any chances on the exam, which is why I continued therapy and I finally saw my PCP, who prescribed me an SSRI. It was scary to start it during dedicated, but I think it was one of the best decisions I’ve made surrounding Step 1. I’ve been putting it for too long and it definitely would have hurt my studies if I had a bad episode!
Again, mental health >>>
Hope that helps! As always, let me know if you have any questions.
With lobe,
Kelly
