BEST PRACTICES DURING STEP 1 PREPARATION 

Every year, the average Step 1 score has gradually increased and has played a pivotal role in selecting candidates into a residency program. USMLE to Match journey is often daunting and, without proper guidance, can often drag for years. On average, IMGs spend 7-9 months to prepare for the USMLE Step 1 exam. By informing yourself about the best practices to include while studying, you can shave the time by a month or two and still secure a competitive score on your exam.

We at USMLESarthi have been working to make IMGs dream of a Residency in the United States a reality (www.usmlesarthi.com). Using our students' feedback, we wish to educate you about the best practices to include during your USMLE Step 1 exam preparation. Implementing their feedback, we have also created a web-based study planner primarily focused on the IMG community's needs. Check out USMLESarthi Step 1 Study Planner for more information on how to study effectively for the exam.

​We have realized that at the Core of an individual's preparation, there are three aspects where students must commit best practices: Resources, Preparation, and Focus. For each, we have identified the top 5 best practices that have the potential to help your Step 1 performance.
RESOURCES
  • Qbank – UWorld
    Reading resources – First Aid (for all subjects)
    1. Additional reads:
      1. Pathology 
        1. Pathoma book and lecture videos
        2. Dr. Goljan audio
      2. Board and Beyond videos
      3. Microbiology
        1. Sketchy medical videos
      4. Pharmacology
        1. Sketchy medical videos
      5. Biochemistry
        1. Dr. Sam Turco videos
      6. Physiology
        1. Costanzo
      7. 100 cases by Conrad Fischer
      8. Anatomy shelf notes
      9. High yield topic notes
  • ​Resource selection
    1. Careful thought and research is done when selecting resources. Weak topics need supplementation and require constant review
  • UFAPS Method 
    • Uworld question bank
    • First Aid
    • Anki flashcards
    • Pathoma
    • Sketchy Medical
  • Study Schedule/Planner (online)
    • Helps build a daily schedule based on when you are taking the exam, hours you can spend a day studying and what resources you are using.
    • It does the work of dividing up how many pages to read, number of questions and lecture videos across the study schedule. Sticking to an individualized study schedule will help one reach their target USMLE score. 
  • Start early!
    • Start annotating First Did during your first and second year of medical school.
    • Try out different resources and see what works best for you (pre dedicated phase).
    • During your dedicated phase stick to it and do not try new resources.
    • ANKI (free)
      • Helps with long term retention (spaced repetition). Prepare your own deck (labor intensive) or access premade decks (eg. Anking, lolnotacop)
PREPARATION
  • 1st round of uWorld:
    • System wise tutor mode
  • 2nd round of uWorld:
    • Incorrect/Marked OR
    • Entire Qbank again BUT random timed mode
 
*this approach varies but most students follow this method.
  • Anki
    • Spaced repetition is a research backed method of studying (2). This method focuses less of passive recall and more of active recall (studying from books is considered one of the least effective ways of studying)
  • ​Using a white board to review and if possible, teach someone the concept. This helps a student better grasp the concept.
  • Incorporating concepts learnt during uWorld questions into First Aid reads. Focusing on uWorld tables and educational objectives as well.
  • Consolidation phase
    • 3 – 6 months
    • Learn concepts and collect information
    • Crucial period
  • Revision phase
    • 2 – 4 months
    • Second review of uWorld question bank.
  • Precision phase
    • 1 – 2 months
    • Ramp up the # of blocks/day
    • Focus on weakness and focus on building good test taking strategies.  
FOCUS AND SCHEDULING
  • Joining an online Skype library for USMLE and finding likeminded individuals with whom you can share this journey.
  • Simulating exam conditions 3 weeks and 2 weeks prior to the exam will help one to acclimate better to the real exam.
  • A dedicated study area with limited distractions is a must for a student studying for step 1.
  • Building good test taking strategies
    • Read and decipher questions faster every day from day one.
    • Focused reading to pick up on what is relevant in the question.
    • Come up with an answer even before you submit the answer.
    • Mindset to brainstorm a solution to the question in front on you. 
    • If incorrect, ask yourself why did I get it wrong and how can I learn from this mistake. 
  • Reverse learning. Use a High Yield resource and at the end of the read quiz yourself. This will help reinforce concepts and check if you have understood the concept.
  • Be prepared and ready for the hills and valley. During one’s preparation we will have good and bad days. Understanding that as a normal process of learning will help one to keep pushing through the prep.
  • Give yourself as many opportunities to make mistakes. Focus on learning from the mistakes and not repeating it again. Earn points and not lose them.
  • Focus on doing as many questions as possible. 60% learning from questions and 40% from reading or lecture videos.
  • Do it once and do it right.
​Written by
Sukrut Pagad, MD, AP